HomeMy WebLinkAboutStreet Cut Permits 10 Beechnut Lane (2) 1400088 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/01/2014
GIS ID: 08400010 FEE: 25.00
MUNIS APPLICATION# 201400472 EXPIRATION DATE: 05/01/2015
APPLICANTka LOCATION
NAME: TELE-NETWORKS = ADDRESS: 10 BEECHNUT LANE
ADDRESS: 31 BAKEWELL COURT OWNER: CONNLLY DANIEL F III&AMBER M
CRASTON,RI 02921 10 BEECHNUT LANE
SOUTHH WINDSOR,CT 06074
PHONE 401-461-8420
WORK DESCRIPTION: INSTAL,REPLACE CATV -
- ,
AF
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=7VIAINTENANCE 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/I/20149:37AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: / /0, 99 CONTRACTOR: :Lf-le- jVE' Qrts
LOCATION: i6een_ /I a-JJ Za of
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: ,
WORK IN
PROGRESS: j tit G�qTy
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: V DATE.
S/2014 Town of South Windsor INPSECTION 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 06074 FEE $25.00
Name of Firm `�V' 1�' �� Phone No.l
Address of Firm 1 f o C eru Zip Code G U U
Location of proposed work
Describe fully nature of permit requested_ 11/1 .Vj� ( ^�C---p (A I V
/C beecti n✓� Gu„e )-o co(�Z; o� b�ec�in�� Line- a-7d SYc gM rt RD
Starting date q/99/,1100 Call Before You Dig No aL�jy/70,��3�i
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: 2d No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
J � A No.cuts
t/\ 0 Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est.Patch Cost$
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$
Applicant is responsible for contacting the Police Dept.and C.B.Y.D OCash OCheck#
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'$STREET T PERMIT MANUAL.
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d: Print Name ) "',� t Date: �5 /
Excavatio Permit 2014
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