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HomeMy WebLinkAboutStreet Cut Permits 1101 Pleasant Valley (3) 1400149 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 06/06/2014 GIS ID: 72601101 MUNIS APPLICATION# 201400723 = FEE: 0.00 EXPIRATION DATE: APPLICAM-Tf LOCATION NAME: METROPOLITAN DI TRIO ADDRI; S: 11t I EASANT VLY CONDO ADDRESS: 125 MAXIM ROAD - PAGE IJANNE N HARTFORD, CT 061 -34 CXN LEWOOD DRIVE y „� PHONE �UIIVINDSOR, CT 06074 = , WORK DESCRIPTION: RELE � NDT { 609 / ,. APPLICANT AGREES TO FURNISH THOTOW-N O OU II WI1kID 0I HE"AM{F VT J g ND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY=I 3�PEI�I§ES INCJRREI3Y THE T�WI FOIE MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE APp Zt ANT I FAAR WH A1D III L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN l F SOUGH VYINDSII STREEYCIIT PERMIT MANUAL. B � ISSUED DA ECTED INSPECTED BY 6/6/2014 1:41 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** go NmQ wMR ,, i TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: yn Ur_ LOCATION: l/C?I & 5aa ed TYPE OF WORK: s DATE INSP NEEDED: DATE INSP: INSPECTED BY: 49 WORK IN PROGRESS:-- SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT:_ DATE: 3� 1 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. ...:..:: ..:.:.::..TOWN`.H.R.LL.:.^f540 St:4LLkVA�!-.AU.ENU.E....SQ:UTH:WINDSOR,CTt�06074...........:.:...:::.:ff�E'...__:...,........:......:........_......_....:. Name of Firm � AC MF Ta 0 L jTAN A WI(C'T Phone No., %0.• I b"l �, M M f2F] C ^ zip Code i Address of Firm L P K) Location of proposed work Q l � S y I V Describe fully nature of permit requested ©( i$ n09LACE fv10211A14 911040 r WD Starting date f "7" Call Before You Dig No T IS A PRELIMINARY ESTIMATE. APLEASE PPLICANT ISRESPONS RESPONSIBLE FOR EEFU PERMANENT COST OF THE PERMANENT PATCH AND CB REPLACEMENT,INC UDING ANY THE INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'$CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut Pavement Cut Curb Cut ❑ Sidewalk Out ❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: Public Water O Well Sewage Service: ❑ Public Sewer ❑ Septic Show sketch of proposed work or furnish indicate North This se ion to be fllled out b Town two copies of separate drawing 0 No.cuts- Est. Patch Sizes} sf Est.Pvt.Thickness in. Est.Patch Unit Price$ /sf 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 Arnt.of Deposit$ Total Due$ ( )Cash ( )Check# Applicant is responsible for contacting the Police Dept.and C.B.Y.D Paid By PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR NY EXPEN INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THAT l AM F I R ITH A D WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED N THE TOWN OF SOUTH WINDSOR' C P NUAL. �,( ( . Signed: Print Name jo"� "-Nvv� Date: Street Excav on Permit 2014