HomeMy WebLinkAboutStreet Cut Permits 88 Dawn Drive (2) 1400297 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/30/2014
GIS ID:26400088 FEE: 25.00
MUNIS APPLICATION# 201401389 EXPIRATION DATE: 09/30/2015
APPLICANT LOCATION
NAME: ADVANCED CONSTRUCTION ADDRESS: 88 bA DRIVE
ADDRESS: 5 CHESTNUT HILL ROAD; ; OWNER: IARANIKIS MARIA
STAFFORD SPRING,CT---06076 88 DAWN DRIVE
SOUTH VINDSOR,CT 06074
PHONE 860-519-8442
WORK DESCRIPTION: INS TALI.REPLACE CAW
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOU QUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY T14E TO�?UNFOR IYfAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND WILT ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATIE INSPECTED INSPECTED BY
9/30/2014 11:26 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Z Y00 aq 7 CONTRACTOR:( lld��o� C'eo l� .
LOCATION: as Paly)("N D'A i we..
TYPE OF WORK: 1(1 1a(C CAA V
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: $D
WORK IN
PROGRESS: 1)VA, �. t5�rN,cj-;ors C797-y
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C`V— DATE:
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.
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm �'�Gr� ' :� `
S Phone No. L��
Address of Firm ,, h r�
s P CT Zip Code
Location of proposed work_ S� Q
Describe fully nature of permit requested______ n fQr
Starting date
Approx. time for completion p
Call Before You Dig No. Existing Water Supply: ❑ Public Water
❑Well
Existing Sewage Service: ❑ Public Sewer
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS Aseptic
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish
two copies of separate drawing This section to be filled out by
Indicate North Town of South Windsor
No. cuts
Est. Patch Size(s) . sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$_-___/sf
0
Est. Patch Cost$
Est. Curb Replacement T ft
Est. Curb Unit Price$__eft
-✓ Est. Curb Cost$
Est. Traffic Unit Cost$
Est.Traffic Control$_____
Amt.of Deposit$
Total Due
( )Cash ( )Cheek#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D. 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.
9
Signed:_ P / 1�ti'V
Title: Dater
Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08