HomeMy WebLinkAboutStreet Cut Permits 69 Kelly Road (2) 1400079 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/29/2014
GIS ID:49500069 FEE:MUNIS APPLICATION# 201400451 25.00
EXPIRATION DATE: 04/29/2015
25.00
APPLICANT LOCATION
NAME: AIROLDI'S INC. ADDRESS: -6 KELLY ROAD
ADDRESS: P O BOX 71 OWNER: SMITHDAVID J&
SOUTH WINDSOR, T�}6074 69 .KELI Y ROAD
SOUTH WINDSOR,CT 06074
PHONE --
WORK DESCRIPTION: DRIVEWAY
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 WINDSR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
4/29/2014 11:05 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l 7 W O -7 9 CONTRACTOR: Al rOl C1l
LOCATION: 6 �y
TYPE OF WORK: jb ` a
DATE INSP NEEDED: DATE INSP: �-';t� I s
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L DATE:
S/2014 Town of South Windsor INPSECTION REPORT 14
= APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25:00
Name of Firm \'���a\c� , s � c, Phone No.
Address of
Location .a _ �a `l\ o„.ti.�rJ'.N t�.sb� e,i Zip Code o(,0*11 j-
Location of pmp�o{.s�ed
Dew"fully nature of perrnk reQU@Sted ���\(mac Q M �C:Vaw Pay oJ�O�i Anl:lh��
e
Starting date 30 `- Approx.time for completion
W
�o v- �o0 3 Public Water L7
eh
Call Before You Dig-No. ExisOng Water Supply' ❑ .
Existing Sewage Service: ❑Pubic 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;INCLUDM ANY INCREASES BI PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWW.$CONTRACT COSTS. THE PERMANENT PATH t IS TYhICALLY
COMPLETED WITHIN A=YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR:
.Show sketch of proposed work or iumish Thls section to be filled out by
two copies of Indkae.Noflh Im.d Sam w dsor
No.cuts
3 Est.Patch Sme(s) Sf
Est.Pvt Thkk less in.
t Sf
Est.Patch Unit Pdoe �
Est Patch Cost>:
`Za .
Est.Curb Replacement h:
Est.Curb Unit Price i ITt
.. EsL CmbCosts
_ Est..Traffic Unit Cost$ ------Mr
i Het:Tndit Control t
Amt.of Deposit$
Total Due s
Applicant is responsible for contacting Paid By
the Porm Dept.and C.B.Y.D..
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 WIU.ABIDE EY THE.RULES:AND REGULATIONS FOR.
PERMIT OUTLINED IN,THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIIT MANUAL.
Signed- �,�� 14
Title: Orivees;License#:
PLEASE ALLOW AT LEAST TWO WORKING:DAYS AFTER APPUCATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UN71L A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSM AT ALL TIMES
sbedbocmuon Pem-dt 08 REV 10-22-08