HomeMy WebLinkAboutStreet Cut Permits 70 Stanley Drive (3) 1400101 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 05/01/2014
GIS ID: 85200070
MUNIS APPLICATION# 201400488 FEE: 25.00
1yXPIRATION DATE: 05/01/2015
APPLICANT LOCATION
NAME: ADVANCED CONSTRUCTION ADDRESS: 76-STtNLEY DRIVE
ADDRESS: 5 CHESTNUT HILL ROAD: OWNER: "- MICHAUD LUC&RITA
STAFFORD SPRINGS T U66°76 70 ST ANLEY DRIVE
SOTJTH WINDSOR, CT 06074
PHONE 860-519-8442
WORK DESCRIPTION: INSTALL REPLACE-ATV
AC
APPLICANT AGREES TO FURNISH THETON OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIRY 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 WINDSR'S-STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
5/1/201411:35AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I L1601 d / CONTRACTOR: 0 , d 60 Hrc�Y>�//lz��✓l��J
LOCATION: `7® 6 -f �J�
TYPE OF WORK: 1 t'� I rev la C —t V
DATE INSP NEEDED: DATE INSP: 7 /S
INSPECTED BY: MD
WORK IN
PROGRESS:
c>
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: LNNI� DATE:
S/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 $25.00
Name of Firm Phone No. �D 5 Eel
Address of Firm4,-1,�Zip Code
Location of proposed work
Describe fully nature of permit requested
,1 l E:L4 i
Starting date U 4 4\ Approx. time for completion_
Call Before You Dig No, q
D , ® Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No. cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
1 Est. Patch Unit Price$ /sf
Est.Patch Cost$
Est. Curb Replacement ._ It
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 By
the Police Dept.and C.B.Y.D.
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: P //�21G'V Date:=lToS, r� 1
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