HomeMy WebLinkAboutStreet Cut Permits 26 Windy Hill Dr (2) 1400098 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: OS/O 1/2014
GIS ID: 95400026
MUNIS APPLICATION# 201400485 FEE: 25.00
EXPIRATION DATE: 05/01/2015
APPLICANT LOCATION
NAME: ADVANCED CONSTRUCTION
ADDRESS: 5 CHESTNUT HILL R(rtl ADDRESS: 26-WIhJDY HILL DRIVE
OWNER: BAILEY DERRICK A&
STAFFORD SPRINOS,,CT 06076
26VINY HILL DRIVE
PHONE 860-519-8442 SOUTH WINDSOR,CT 06074
WORK DESCRIPTION: INSTALS REPLACE CATV
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND THE TOWN OF SOUTH WINDSOR FOR AN REQUIRED AND TO REIMBURSE
Y EXPENSES INCURRED BY THE TOWN FOR=INIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TAE APPLICANT IS FAMILIAR WITH AN WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S STREET CUT PERMIT MANUAL.
ISSUED BY
DATE INSPECTED 1
INSPECTED BY
5/1/201411:26AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ®D6 CONTRACTOR: Pn��hrjn q
LOCATION:
TYPE OF WORK: I yl ri
DATE INSP NEEDED: DATE INSP:_
INSPECTED BY: `�
WORK IN
PROGRESS: t J
tir
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No, TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm "�Gr� ' Phone No. �C
Address of Firm_ C; Ch r,�
Location of proposed work f—�—�T_Zip Code
Describe fully nature of permit requested 1 f� �-� 11 /Y P n 1 n r
v"'ja1Al
Starting date__ Approx, time for completion �; 2
Call Before You Dig No. - ExistingWater Supply:pp y ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
ES TYPI
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH CALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish
two copies of separate drawing This section to be filled out by
Indicate North Town of South 0 Windsor
No. cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in,
Est. Patch Unit Price$ lsf
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ —eft
__ --—
Est.Curb CostIL $
Est.Traffic Unit Cost
Est.Traffic Controls_ t
Amt.of Deposit$
Total Due$
( )Cash OCheck#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D. Paid By
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:_ • P f/ .''V.1
Date:
Title:
Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08