HomeMy WebLinkAboutStreet Cut Permits 31 High Street (2) 1400300 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/06/2014
GIS ID:42000031 = FEE: 25.00 _
MUNIS APPLICATION# 201401413 EXPIRATION DATE: 10/06/2015 _
APPLICANT = LOCATION
NAME: AIROLDI'S INC. ADDRESS-- -IG STREET
ADDRESS: P O BOX 71 4� lERfERMN ROGER F&GAIL A
SOUTH WINDSOR,lc " 7-4 „ 3I 141-ARSTREET
7IJTFI INDSOR,CT 06074
PHONE
WORK DESCRIPTION: DRIEWWY = =
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THIIAMOI III O'' Q 1D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIRY EXPENSES INCURRED BYTHE TOWN FOLfiAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WI I AND WI-ifABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR, STREE T CUT ERIVIIT MANUAL.
�as-
ISSUED BY DATE-INSPECTED INSPECTED BY
10/6/2014 9:24 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
---- - -----------
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 qt__,Q l90 CONTRACTOR:
LOCATION: J j h 5 jreef
TYPE OF WORK:___ __ A'] w(.'L)a Ca
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: ��- DATE:
J
S/molloy/forms 2014 Town of South Windsor INPSECTION 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 $25.00
Name of Firm ��a��;. s �� Phone No.
Address of Firm -� Qn � N . , Zip Code d 60 n uc
Location of proposed work
Describe fully nature of permit requested
Starting date Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut El Curb Cut ❑ Sidewalk Cut
XExisting Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est.Patch Size(s) sf
.� Est.Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est.Curb Replacement ft
4t
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
�!1 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
WINDSO EET CUT PERMIT MANUAL.
Signed: �� Print Name `��`�*'� ° � ��+' Date: �O 3
Street Excavation Permit 2014