HomeMy WebLinkAboutStreet Cut Permits 190 Debbie Drive (2) 1400106 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 05/06/2014
GIS ID:26700190 ;
MUNIS APPLICATION# 201400519 = - FEE: 25.00
EXPIRATION DATE: 05/06/2015
APPLICANT -, = ,. LOCATION
NAME: AYOTTE BROTHERS CONT CO �DDR 19a DBBIE DRIVE
ADDRESS: P O BOX 498 l' NER WAKSMAN LAWRENCE S&DONNA B
SUFFIELD,CT 06001011
1AfD1$BIE DRIVE
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PHONE 860-654-1800 IN = bvTHWINDSOR,CT06074
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WORK DESCRIPTION: DRBWAY - = '
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APPLICANT AGREES TO FURNISH THE TO i OF SOUT O
If�IN 80 FHE AM INT{) BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY- XPENES-INCURRI<t SYTHE TOVVI*IFOt`MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIDE 1'PLICANT IS 1 AMILIAR Nil H A JD W1I L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WIIVDSR'S STREET CUT PERMIT MANUAL.
ISSUED BY
DATE INSPECTED INSPECTED BY
5/6/2014 2:39 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: f)0/O�o CONTRACTOR:. �7t"E ,�YD �'iP� CpV1� G11.
LOCATION: /90 l e,�6jp b V�P
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: ;/,n%„
INSPECTED BY: fil)
WORK IN
PROGRESS: c L ,ll
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.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm ;fie 3.41 -( 0-m Ce-:, ,r(1 Phone No.
Address of Firm - -o YS c,7/ qj d' Zip Code io®
Location of proposed work I c! b openQ F,�,.,,-r(� �,c.,� ��
Describe fully nature of permit requested en-n pdclp 4 11kADk" "71Q
Starting date waaA v4 =/9- /y Call Before You Dig No c9o/14 17 D pq 3
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: . ❑ No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
El' Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Zl— Est. Patch Size(s) sf
u0mKiij
J Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
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$
r
Est.Traffic Hours hr
i
Est.Traffic Unit Cost$ /hr
�S _ 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 STREET CUT-PERMIT MANUAL.
Signed ( Print Name, a Od Oci MQcbow ( I Date: —��' - 8
Street Excavation Permit 2014