HomeMy WebLinkAboutStreet Cut Permits 98 Homestead Drive (2) 1400216
TOWN OF SOUTH WINDS
OR,
NUMBER O R, CT
DATE: 07/21/2014 STREET CUT PERMIT
GIS ID:44700098
MUNIS APPLICATION# 201400990 FEE:
EXPIRATION DATE: 25.00
, 07/21/2015
APPLICANT
NAME: TELE-NETWORKS = = LOCATION
ADDRESS: 31 BAKEWELL COU�'R`I ADDRESS; 9g=112 HOMESTEAD DRIVE
CRASTON,RI 0292L OWNER SANDl ROBERT C&HOLLY H
98O1MESTEAD DR
PHONE 401-461-8420 = BOUTH WINDSOR, CT 06740-0000
WORK DESCRIPTION: RE PLAEE CAS V '
APPLICANT AGREES TO FURNISH THE TOFI OF SOUTH WINDSOR THE AMOiT pF gND REQUIRED AND
THE TOWN OF SOUTH WINDSOR FOR ANY3�PEN,SES INCURRED BY THE-TOWN-FOR AINTENANCE OR REPAIR WORK IN TvI
TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WISH AND WILL ABIDE BY THE RULES AND REGULATIONS
C5
FOR PERMITS AS OUTLINED IN THE TOWN F SOUTH WINDSR'S STREET CUT PERMIT MANUAL.
ISSUED BY h -
DATEINSPECTED
INSPECTED BY
7/2 1/20 1 4 2:44PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 CONTRACTOR:_ �'��
LOCATION: S 4f 6-ck br
TYPE OF WORK: -,(-ep kQ ce CA-t V
DATE INSP NEEDED: DATE INSP: 3
INSPECTED BY:
WORK IN
-�
PROGRESS:
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.
� j,,_
TOWN
,HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 060774 FEE $25.00
Name of Firm ' Ive ijl OV-J" ��P-hrone No., ��0' S�rJ' 22 30
Address of Firm V `e t�.� Zip Codev2QQ
Location of proposed work 4-1 X eAlzS k )[' r
Describe fully nature of permit requested tRdigg e CATU
Starting date 7—`g Call Before You Dig No,.-,�UI4 a9U .1575
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
K Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
0 Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price
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 STREET CUT PERMIT MANUAL. ��/��+ j� 1n
Signed: PrintNaZXTItC,1 IJ �M�P Date: '7''/6--N
Street Excavation Permit 2014
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