HomeMy WebLinkAboutStreet Cut Permits 324 Deming Street (2) 1400328 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 11/06/2014
GIS ID:27600324
MUNIS APPLICATION# 201401611 FEE: 25.00
EXPIRATION DATE: 11/06/2015
APPLICANT LOCATION
NAME: TELE-NETWORKS ADDRESS: 324 DEMING STREET
ADDRESS: 31 BAKEWELL COURT OWNER: WALLACE MATTHEW W
CRASTON,RI 02921 324 DENTING STREET
PHONE 401-461-8420 SOUTH WINDSOR,CT 06074
WORK DESCRIPTION: REPLACE EXISTING CATV
APPLICANT AGREES TO FURNISH 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 THE APPLICANT IS 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.
ISSUED BY ' DATE INSPECTED '��
INSPECTED BY
11/6/201410:07AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: 1eo-
LOCATION: 3e 0 1 p,
TYPE OF WORK: e,�' �—
DATE INSP NEEDED: DATE INSP: 2 <5
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
Inn /
INPUT: U" DATE: �-
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
iTO,,WN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 0�6+0774 FEE $25.00
Name of Firm ' Iv'c�Wor" Phone NoA.V 0' NIS zV
Address of Firm V In Zip CodeoZgo
Location of proposed work ki CI sli.
Describe fully nature of permit requested_ Cf a(AC-P -e KA 9-j 0 C A 11J
Starting date 1�� y� _ �Q\�-{ Call Before You Dig NoaQkq `- qo 39gq
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: 2/No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
�e 0No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ /ft
Est. Curb Cost$
Est.Sidewalk Replacement sf
Est. Sidewalk Unit Price
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 T U RMIT MANUAL.
Si c Print Nam Date:
�Q� t'CS IJ �M"J�
Str et Excavatio ermit 2014
1ATA2-Work Order Display-Site 216
❑ x
File Edit Billing Services Customer Information Order Entry PPV Financial History HSD Help
OK Acct Nbr 483662-03 Task
EYit Matthew Wallace Co/Dv/Frn 51 10 426 Cust Info Pit "I'Vio
324 Deming St Phone# Home 860 331-0040
South Windsor, CT 06074-3713 Bus Tech # 0
Exit and Retain Q Code E BURY DROP Job Seq
Menu Priority 5 Pool J Job Nbr 000 Tag Nbr 459756
Pts Work Order Number 19214711 Problem Code
Svcs Work Order Type SR special Request Addtl Problem Codes
Work Order Status Not Coded Primary Finding .
irne SlotsDispatch Comment [�! Primary Solution .
Work Order Comments 17MP IN PLACE 150 NO BORES Pri Loc SW4
Tech Flash Sch Date 11/14/14 PED CST FOSTER Sec Loc
Sch Time ALLDAY TN 10-30 Node ID SUE60
Comments
Ckin Usr _ Stage
'Cat Occ Service From To Amount Pnts E ID
C 1 VDROP DROP TLTORK 1 .00 6 15171 DMATTEO
46, IF ox/.
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