HomeMy WebLinkAboutStreet Cut Permits 39 Alexander Place (2) 1400215 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/21/2014
GIS ID: 01500039 FEE: 25.00
MUNIS APPLICATION# 201400988 - EXPIRATION DATE: 07/21/2015
APPLICANg- = LOCATION
NAME: TELE-NETWORKS - ADDRESS: 391L1EXANDERPLACE
ADDRESS: 31 BAKEWELL COURT OWNER: KUNZ SHARON S&DONALD A
CRASTON,R10292f , 39 AZIANDER PLACE
SOUT�I VINDSOR,CT 06074
PHONE 401-461-8420
WORK DESCRIPTION: REALACE"CAI V
APPLICANT AGREES TO FURNISH THE I OW T OF SOUTH WINDSOR"THE AMOUNT OF 46ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY PEN ES INCURRED BY THE TO W�F&OMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TAE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S S REET CUTPERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
7/21/2014 12:56 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: Q - o k_
LOCATION: 39,
TYPE OF WORK: f 6je 1,T cp C Al V
DATE INSP NEEDED: DATE INSP: a �
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: G DATE:—I) jis'
S/2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
�T(O�W,.(N,.HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 060774 p FEE $25.00
Ivy
Name of Firm ' Iwor Phone NoA-Wg- O4S- Z302
Address of Firm V V\ .e 41 Zip CodevZgo
Location of proposed work J-c� ser kt7 �(� �1 . Pl a-y AnckC,e-0 Ste' " 3`t Alrafc l �j
Describe fully nature of permit requested t ep,& . em v
Starting date 2-1 Call Before You Dig Noa'nk q a 0;1$"2v-2,y/y.4 70 257,
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: X 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
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. '''�� rrM1M1 nn�+ j� 1n
Signed: Print Name�la`` 03 tJ �M X O� Date: 7'16'J y
Street Excavation Permit 2014
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