HomeMy WebLinkAboutStreet Cut Permits 75 Tumble Brook Drive (2) 1400265 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/04/2014
GIS ID: 90600075 FEE: 25.00
MUNIS APPLICATION# 201401239 = IaXPIRATION DATE: 09/04/2015
APPLICANT "_ LOCATION
NAME: TELE-NETWORKS ADDRESS; 7 8 ;TUMBLE BROOK DRIVE
ADDRESS: 31 BAKEWELL COIITR OWNER: TROUIt AS MICHAEL&ELVA J
CRASTON,RI 0292 75 TT7N$LE BROOK DR
INDSOR,CT 06074
Pill
OUTH
PHONE 401-461-8420
WORK DESCRIPTION: REAL ACE CATV - /
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH"WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A�PENSES INCURRED BY THE TOWN FORIvIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AhID WIT,L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN SOUTH SOUTH WINDSOWS STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
9/4/2014 9:05 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: J 41W62 6 CONTRACTOR: A£'/P- /l,{'�7i�OV', S
LOCATION: 7S S 1-6mb)e 6A0nL bT
TYPE OF WORK:_ tCp 1ae-- C:A-r IZ
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: Nett C/-MV
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:— DATE: 'I_� �
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
*TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 0�6+0774 p FEE $25.00
Name of Firm ' 1�kitoor� �P-hrone NoA-V 0' 0�S- 'ZWZ
Address of Firm V U� ze ?—I Zip Code Ozga
Location of proposed work 75- v,n 26tvok
Describe fully nature of permit requested ace`,? ,4 V
Starting date 1- - r!y Call Before You Dig Noa0k4 - 6)_2 6
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Qt
�( Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price$ /ft
Est. Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt. of Deposit$
Total Due$
( ) Cash ( )Check#
Applicant is responsible for contacting the Police Dept. and C.B.Y.D
PERMIT SHALL 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 STRrjn CUT PERMIT MANUAL. /,�
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