HomeMy WebLinkAboutStreet Cut Permits 45 Cadbury (2) 1400303 TOWN OF SOUTH WINDSOR, CT '
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/06/2014
GIS ID: 15900045 FEE: 25.00
MUNIS APPLICATION# 201401419 EXPIRATION DATE: 10/06/2015
APPLICANTXF - LOCATION
NAME: TELE-NETWORKS = ADDRESS- 45-50 ADBURY
ADDRESS: 31 BAKEWELL COUNT €-i-NER -- RSENUM MICHAEL D&NANCY KELLY
CRASTON,RI 02921 ADURY
[JT INDSOR,CT 06074
PHONE 401-461-8420 ""
WORK DESCRIPTION: REPLACE EXISTING CATV
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WIN-bso x-ft AMOtW, OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC'EXPENSES INCURRED BY�THB TO j-, N4IfAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THAPPLI.CANT IS FAMILIAR WITH AND WIIfI ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S,STREET CLITPEI III MANUAL.
ISSUED BY DATE INSPECTED INSPE ED BY
10/6/2014 11:08 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION: - C.adb i., c t
TYPE OF WORK: ate L'da C
DATE INSP NEEDED: DATE INSP: iAS
INSPECTED BY: EZ
WORK IN
PROGRESS: I—ele - /Vc+i y '!A o /4mod Ca Jr
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: LAPI- DATE:
S/molloy/forms 2014 Town of South Windsor INPSECfION 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 $25.00
Name of Firm Te`� -tJetwo(-�--S Phone NoJ, 8E.34G-2302
Address of Firmj1,-� 6co V &. 4 enVICU V1 a (Zi Zip Code OZ(RU3
Location of proposed work q 5-5 d G694)(-� 1�
Describe fully nature of permit requested �2eace x\��1 G� cog T V
Starting date d' '. y Call Before You Dig Noa6� Vag/9,),g
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS, THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: PC No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing I
feeaC" No. cuts
0 Est. Patch Size(s) sf
Est. Pvt. Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
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-SffREET/CU PERMIT MANUAL. �]
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