HomeMy WebLinkAboutStreet Cut Permits 1101 Pleasant Valley (2) ------------------------------------------------------------- --
1400195 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/07/2014
GIS ID: 72601101 = FEE: 0.00
MUNIS APPLICATION# 201400891 --PIRATION DATE:
01
APPLICAN- = LOCATION
NAME: METROPOLITAN DITRICT / ADDRESS: 1 ITI PLEASANT VLYCONDO
ADDRESS: 125 MAXIM ROAD = =OWNER PAGE PANNE N
HARTFORD,CT 061�} = 3i CAN LEWOOD DRIVE /r
y - SOH1IVINDSOR,CT 06074
PHONE = =
WORK DESCRIPTION: REAL aC I4�DR�1NT W/O 56081&9 ,
APPLICANT AGREES TO FURNISH THA O -F SOUTH WINDSORAHE AMO[�NT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AJY= PENSES INC3RRED:BI'TIIE TOWItI FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIE APPLICANT IS FAMILIAR WI I H AI �YLL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN`CIF SOUTH WINDSR'S STREETGUTPBRNIIT MANUAL.
ISSUED BY DATEINSPtCTED INSPECTED BY
7n12014 10:45 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: �� 9S' CONTRACTOR: X DC
LOCATION: I.Ja IRy
TYPE OF WORK: 'I l" boll) /0 f
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 19 D
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:_ DATE:
S/2014 Town of South Windsor INPSEMON REPORT 14
MD-039,aevti,2" THE METROPOLITAN DISTRICT- PAVEMENT CUT DATE:
ADDRESS 11 DILL JO3 ❑..YES.:.-UNM- WO#
CLOSEST STREET •T-'VY TOWN STATE HIGHWAY ❑YES & O
DRAW SKET H SHOWING LOCATION AND SIZE OF CUTS AND
CUT MADE IN i
CROSS SECTION OF PAVEMENT
❑STREET LIBITUM,—
" ❑CONC.—" El PREMIX
f� ❑SIDEWALK ❑BITUM. ❑CONC—" ❑FLAG
❑CURB ❑BITUM._' ❑CONC. ❑STONE
�/ ❑DRIVEWAY ❑BITUM._" ❑CONC.—"
1' v 4a15HASS LOAM&SEED NEEDED OYES [NWO
REASON FOR CUT: 7',ir yyv
U,1'r0- S-6 4-7— 4t
\ DEPTH OF EXCAVATION: 5' F7-
�T NUMBER OF CUTS:
C� DATE OF FIRST CUT:
IS JOB COMPLETED: D'S'ES ONO
FOREMAN:_ 4ZI-�Y &4- i
REPLACEMENT PAVEMENT CONTRACT NO
BITUMINOUS ❑ CONCRETE❑ PREMIX❑
DATE COMPLETED:
ACCOUNT NUMBER: C `L• P'
CALCULATIONS
OF CUr ITEM# ITEM# ITEM ITEMS �
6-
L�f.
PRESS HARD, S COPIES PAVING INSPECTOR CONTRACTOR.
(ORGINAL) (YELLOW)