HomeMy WebLinkAboutStreet Cut Permits 75 Skyline Drive (2) 1400326 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 11/06/2014
GIS ID: 83100075 FEE: 25.00
MUNIS APPLICATION# 201401609 EXPIRATION DATE: 11/06/2015
APPLICANT LOCATION
NAME: ADVANCED CONSTRUCTION ADDRESS: 75 SKYLINE DRIVE
ADDRESS: 5 CHESTNUT HILL ROAD OWNER: HULL LINDA P
STAFFORD SPRINGS, CT 06076 75 SKYLINE DRIVE
PHONE 860-519-8442 SOUTH WINDSOR, CT 06074
WORK DESCRIPTION: INSTALL REPLACE CATV
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.
/ A e 36
ISSUED BY
DATE INSPECTED INSPECTED BY
I1/6/20149:56AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: A ��►2c CQ n�S .
LOCATION: _7S S �[ ^r~P l-►� vC-
TYPE OF WORK: r V
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: A b
WORK IN
PROGRESS: 4dVcL.n C,'ei ,.�s�y�.���, r-ep/a c 24 C .4 f y L.a'"-e
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [:] NO
AS-BUILT:
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm Gr' b �_CF� _��,r1 s %.n G I ne r, c}V Phone No. / Eel 4-a
Address of Firm Cb S ' 4 Zip Code
Location of proposed work ':;Z
Describe fully nature of permit requested k L ,&�
Starting date Approx. time for completion
Call Before You Dig No. 21t-4-t,_Q__�-f Existing Water Supply: ❑ Public Water El well
f Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish _two copies of separate drawing This section to be filled out bvn
Indicate North Town of South Windsor
No. cuts
Est. Patch Size(s) sf
Est. Pvt. Thickness in.
Est. Patch Unit Price$A /sf
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ /it
Est. Curb Cost$
Est. Traffic Unit Cost
Est.Traffic Control$�
Amt.of Deposit$
Total Due
( ) Cash ( )Check#
Applicant is responsible for contacting Paid B
the-Police Dept.and C.B.Y.D. y---
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: � �l�c-� � Date:�Ey��-i��
Title: 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