HomeMy WebLinkAboutStreet Cut Permits 99 Tumble Brook Drive (2) 1400056 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 04/08/2014
GIS ID: 90600099
MUNIS APPLICATION# 201400354 - FEE: 25.00
EXPIRATION DATE: 04/08/2015
APPLICANT
NAME: TELE-NETWORKS LOCATION
ADDRESS 99-TUMBLE BROOK DRIVE
ADDRESS: 31 BAKEWELL COLOR = OWNER ANDEfSON NEAL P&CAROL P
CRASTON,RI 0292I 99` CJIBLE BROOK DRI
PHONE 401-461-8420 = = SOHWINDSOR,CT 06074
WORK DESCRIPTION: REP A-0 EMTINd OA Iv /
APPLICANT AGREES TO FURNISH THE TO YN OF SOUTH WINDSOR TIIE AMOUNT OF I AND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AXY-EXPENSES INCURRED BYTHE TC3WNFOI =MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AI'I'Li ANT IS FAM_1h AR WITH ACID fLL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WTNDSR'S=STREITCUT PERMIT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
4/8/2014 3:49 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_1 CQQ_5(p CONTRACTOR: (`el�of k,
LOCATION:_ "o IC
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
fi r,
INPUT: �� '� . DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
i ,,TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 060774 FEE $25.00
Name of Firm - Iv U)&J" Phone NO-V09. 04S' 'zWz
Address of Firm --la Br6ot-etV N� Zip Codeev2QQ
Location of proposed work
Describe fully nature of permit requested
Starting dateW&L 0E 1 Call Before You Dig No,;M4
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: Ff No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing -
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
Est. Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt. of Deposit$
Total Due$
( )
Applicant is responsible for contacting the Police Dept. and C.B.Y.D ( ) Cash Check#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES 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 5VREET CUT PERMIT MANUAL. Y�A�n/� 1n
Sign '�.- rf j. Print Name�Ol1'�tC V �M"✓�a C( 'y7" 1'f
V Date:
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