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HomeMy WebLinkAboutStreet Cut Permits 25 Apple Orchard Lane (2) 1500001 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 01/20/2015 GIS ID: 03900025 FEE: 0.00 MUNIS APPLICATION# 201500059 EXPIRATION DATE: APPLICANT LOCATION NAME: CONNECTICUT WATER COMPANY ADDRESS: 25 APPLE ORCHARD LANE ADDRESS: 25 NORTH ROAD OWNER: GILBERT-ROBERT A&BONNIE EAST WINDSOR, CT 06088 25 APPLE ORCHARD LA SOUTH WINDSOR, CT 06074 PHONE 860-623-3355 WORK DESCRIPTION: 8'x8'CUT TO REPAIR BROKEN WATER MAIN APPLICANT AGREES TO FURNISH 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 THE APPLICANT IS 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. n /� ISSUED BY DATE INSPECTED INSPECTED BY 1/20/2015 10:02 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ----- -------- ------ TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 165 0 0 o© CONTRACTOR: 10 C LOCATION: 26 dg ele QjeLhaC Z,; n TYPE OF WORK: f� x �'' Cum Re�rahz 16110ken DATE INSP.NEEDED: DATE INSP: INSPECTED BY: � WORK IN PROGRESS: o x_ S �� C � ✓erG �'� SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: Vyv DATE: S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14 dol,LOOo 2 APPLICATION FOR STREET EXCAVATION 'PERMIT Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. ,r� TOWN HALL 15440 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00 Name of tltt »roc$*.— {r sv s '/ ! Phone No. �s0 9dt- ' ..2-Fl/ Address of Fltttt_ A_,&L �,� a r r . C Zip Code A&arf`r Location of proposed wt ek Describe fully nature of permit requested -... Starting date _ - _.. Calt'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 XPavement Cut ❑ Curb Cut ❑ Sidewalk Cut ❑ Existing Driveway, No Changes LJ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic Show sleet of proposed work or furnish two ndicate North This section to be filled out by Town copies`f separate drawing No.cuts Est. Patch Size{s) sf - Est.Pvt.Thickness in. Est.'Patch Unit Price$ /sf _ Est.Patch CosV$ Est,Curb Replacement ft Est.Curb Unit Price,"$ !tt 6 Est.Curb Cost$ �. Est.Sidewalk Replacement sf Est.Sidewalk Unit Price$ /sf Est.Sidewalk Cost$ Est.Traffic Hours {yt .$ Est.Traffic Unit Cost$_ /hr u Est.Traffic Control$_ J,3 Amt.of Deposit$ _..- c� Total Due$ - - { O Applicant 1s responsible for contacting the Police Dept.and C.B.Y.D )Cash Check# -__ PERMIT 8 ALL 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. Signed: JC S -- /14tivs,10 Print ttt>md, f }� _ . irY#-;s(l w 6y D te: Street Excavation Permit 2014 i pf .. 1 _. .., #.,. a. .. ...� �w��..a_ a� Drabek, Bernard From: CallCenter@CBYD.com Sent: Tuesday, January 13, 2015 1:27 PM To: CBYD Subject: Locate Request-20150300725 (CALL BEFORE YOU DIG - CT) 01/13/2015 13:27:13 -5G -Cl -CW -F5 -J1 -OT 4-SW SWINDS -------------------------------------------------------------------------- ***** EMERGENCY ***** TIME. .13:27 DATE. .01/13/2015 REQUEST NO. . .20150300725 LATITUDE. . 41.8631609 LONGITUDE. .-72.5793219 TOWN. . . . . .SOUTH WINDSOR ADDRESS. . .25 STREET. . . .APPLE ORCHARD LN NEAREST CROSS STREET. .FARNHAM RD -------------------------------------------------------------------------- TYPE OF WORK. . . . .EXC TO RPR WATER MAIN BREAK AREA IS MARKED. . .YES REMARKS: WORKING ON ST CURB TO CURB ON FRONT OF PROP CREW ON SIGHT -------------------------------------------------------------------------- START DATE. . . . . .01/13/2015 START TIME. .13:26 CALLER. . . . . . . . . .KEITH WATERHOUSE CALL BACK. . . . . . .8-4:30 PHONE #. . . . . . . . .860-292-2810 FAX #. . . . . . . . . . . ALT. PHONE #. . . .860-205-0605 EMAIL ADDRESS. . . CONTRACTOR. . . . . .CONNECTICUT WATER CO ADDRESS. . . . . . . . .25 NORTH RD CITY. . . . . . . . . . . .EAST WINDSOR STATE. . . . . . . . . . .CT ZIP. . . . . . . . . . . . .06088 ---------------------------------------------- F� - -- , t ---- EXCAVATOR DOING WORK. .SAME ISSUED TO: DATE: TIME: BY: DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY: CALL BACK: 1) DATE: TIME: .BY: 2) DATE: TIME: BY: PERSON CONTACTED: PERSON CONTACTED: 1