HomeMy WebLinkAboutStreet Cut Permits 96 Clearview Drive (2) 1400217 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/21/2014
GIS ID:20700096 FEE: 25.00
MUNIS APPLICATION# 201400991 EXPIRATION DATE: 07/21/2015
APPLICANT LOCATION
NAME: TELE-NETWORKS IADDRESS: 9Fs 18 CLEARVIEW DRIVE
ADDRESS: 31 BAKEWELL COURT`
OWNER IENN*HEODORE E&JANE
CRASTON,RI 0292196 CLBARVIEW DRIVE
UT WINDSOR,CT 06074
PHONE 401-461-8420
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WORK DESCRIPTION: REkAE CATV =
APPLICANT AGREES TO FURNISH THE TOE OF SOUTH-WINDS
OR THE AMOUNT-OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A1 Y=LXPENSES INCURRED,BY THE TOWNFOI1vIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMIffAR WI`I`H ANC L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S VY.IL
OF-SOUTH WIND R'S STREET GUT PE-MIT MANUAL.
a II o
ISSUED BY DATE INSPECTED
INSPECTED BY
7/21/2014 2:47 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /00.2l CONTRACTOR:
LOCATION: 9 6 ' I &
TYPE OF WORK: fee kz cc-
DATE INSP NEEDED: DATE INSP: 3 I S
INSPECTED BY:' !�
WORK IN
PROGRESS: � )� — � cr l ��� C.�TV
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:-
INPUT: DATE:
S/2014 Town of South Windsor INPSEC HON 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 0�6+0774 p FEE $25.00
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Name of Firm ' I 7�wor� Phone NoA �a 0' 0 4 - 2 302
Address of Firm V In Zip Code
Location of proposed work �G-�8b G/� ry "�cd !7� j7"7 .4-,-,e 3-j-�.1 c)r"
Describe fully nature of permit requested Aeph&.e Cf41'(J
Starting date 7'/`1 Call Before You Dig No,' 1Qk ,2,W
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ® No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out bV Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ /ft
Est. Curb Cost$
Est. Sidewalk Replacement sf
Est. Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
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.Y.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 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� �n /� 1u
Signed: Print Name�()lllQ3 V NM'Or L Date:
Street Excavation Permit 2014
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