HomeMy WebLinkAboutStreet Cut Permits 350 Pleasant Valley R (2) 1400117 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 05/19/2014
GIS ID: 72900350
MUNIS APPLICATION# 201400589 0 FEE: 25.00
EXPIRATION DATE: 05/19/2015
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APPLICAI* '
NAME: CABLE CONSTRUCLO�1 G15 / LOCATION
ADDRESS: 405A NEW STATE I 3 ADDRi 35-UPMASANT VALLEY ROAD
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MANCHESTER, CT=O 40 �N1 350 PLEASANT VALLEY ROAD LLC
'` MAIN ST UNIT D
E y % �i TRA FORD CT 06614
PHONE 860-649-8217 -
WORK DESCRIPTION: IN
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AND TO
APPLICANT AGREES TO FURNISH THATO1 O aOUTIII1I? t Imo"
AM
THE TOWN OF SOUTH WINDSOR FOR AIYXgEIt1IS IIIlRR T1IOTQ ENANICREE OR REPAIR WORK INE
CONNECTION WITH THIS PERMIT AND T API IAT`JT I1�A3'1AR yI L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN-CIF SoQtu I DSR STI�TIT MANUAL.
ISSUED BY
DPCTED INSPECTED BY
5/19/2014 2:08 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 7 ��'�� CONTRACTOR: C .51e_
LOCATION: ease o
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TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: /S
INSPECTED BY:
WORK IN
PROGRESS: Ga �l G�h��'✓�e�� ;o,•; �'�s�wl � ��;e �,44,�rn,,� �= .h
feu46L I r C! 40 " '1L41
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/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 06074 FEE $25.00
Name of Firm Ca�/ e0-7 S A'ar f'le, 4a Phone No. S�Eo 6Y4 gsZ/�'
Address of Firm 3- N&v-; -67-av--r, olon J�c� Zip Code OhO D
Location of proposed work Volle 17
Describe fully nature of permit requested Td bcr, /17
Starting date Call Before You Dig No-
PLEASE
D/V-2003 6 5
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: VNo Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(O sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price
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 S T ;PERMIT MANUAL. S�/��/Signed: Print Name ��XSG�-/�oai Date: ��
Street Exca tion Permit 2014
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