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HomeMy WebLinkAboutStreet Cut Permits 9999 Pleasant Valley (7) 1400333 TOWN OF SOUTH U T H PERMIT NUMBER WINDSOR, C T STREET CUT PERMIT DATE: 11/13/2014 GIS ID: 99997290 MUNIS APPLICATION# 201401624 FEE: 0.00 EXPIRATION DATE: 11/13/2015 APPLICANT NAME: GERBER CONSTRUCTION CO LOC_TON ADDRESS: 1 NUTMEG DRIVE ADDRESS: 9999 PLEASANT VALLEY ROAD ELLINGTON,CT 06029 OWNER: TOWN OF SOUTH WINDSRO 1540 SULLIVAN AVE PHONE 860-875-6684 SOUTH WINDSOR, CT 06074 WORK DESCRIPTION: REMOVE AND REPLACE SANITARY MANHOLE INTERSECTION OF PLEAS VALLEY&WHEELER RD TOWN PROJECT NO FEE ANT 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 I1/13/201411:47AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** -------------- TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: / 003-33 CONTRACTOR:- 'e,r r C©nS`421 . LOCATION: 4-94Se6 o n TYPE OF WORK: DATE INSP NEEDED: DATE INSP: 3 i INSPECTED BY: 6 h WORK IN PROGRESS: l y r K 4 5 �� C � �,a-1� c SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: Cam / DATE: o� S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14 Ol 01�)q APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm �c/ G[Gns f- .�h C. Phone No. Address of Firm Zip Code Location of proposed work Describe fully nature of permit requested rye,. d- �co✓a t� ��., , r y �7�.,�..► Starting date 3 /5� Call Before You Dig No 0 G g PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH�T IT COULD BE LATER THAN A YEAR. Check Applicable: El No Pavement, Curb or Sidewalk Cut LPJ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut ❑ Existing Driveway,No Changes ❑ Proposed Driveway WideninVpublic Proposed New Driveway Water Supply: ❑ Public Water ❑ Well Sewage Service: Sewer ❑ Se tic 9p Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing No.cuts N Est. Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price$ /sf r �� 4, Est.Patch Cost$ y' Est.Curb Replacement ft I Est. Curb Unit Price$ /ft Est.Curb Cost$ Est. Sidewalk Replacement sf Est.Sidewalk Unit Price f Est.Sidewalk Cost$ y Est.Traffic Hours hr $+ Est.Traffic Unit Cost$ /hr Est.Traffic Control$ Amt.of Deposit$ Total Due$ ( )Cash ( )Check# Applicant is responsible for contacting the Police Dept:and.C.B. .D 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 CURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THAT I AM FAMILI ITH A WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOW OF OUTH WINDSXS- S CUT P MIT MANUAL. J Signed:oo, Print Name L C� Date. Street E<Cdvation Permit 2014