HomeMy WebLinkAboutStreet Cut Permits 27 Fox Hill Road (2) 1400231 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/31/2014
GIS ID: 33900027 FEE: 25.00
MUNIS APPLICATION# 201401053 = EXPIRATION DATE: 07/31/2015
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APPLICAN = LOCATION
NAME: AIROLDI'S INC. ADDRESS 0 HILL ROAD
ADDRESS: P O BOX 71 -=(3 yNE - AND&SON RUSSELL M AND LINDA B
SOUTH WINDSOR, �(:674 = 27 -HILL ROAD
i - S�iJIVINDSOR,CT 06074
PHONE
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WORK DESCRIPTION: DRP.VVW-,Q
APPLICANT AGREES TO FURNISH TH&O OF SOUTH a'INS?ITHE AMOUNT OF 13OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AYPENI S INCURRED T3Y THE T4WTO IFOIVIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIII API ICANT IFAMfiAR W,L H 4N WL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO ClF S6UTH WINDSR3 STREET GUT PEKMIT MANUAL.
ISSUED BY DATE INSPECTED
INSPECTED BY
7/31/2014 1:48 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: A )rd d1 �S'
LOCATION:
TYPE OF WORK: 1 iLe i i)a(�
DATE INSP NEEDED: DATE INSP: i` r5-
INSPECTED BY: 81>
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: ,
S/2014 Town of South Windsor INPSEMON REPORT 14
.� F � ♦ f �y'��rNA�J��rt���t��yfi�vtF.J'�({tfYrjt�k i x4t:>�1�*�j,�� �� ,. ; ��.tky?''M� iwit�iyY"�S� ' 'Y 'd
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 $25.00
rvame of Firm •��o��` S �N� • Phone No,
Aodress of Firm Q.o r r1 �o�� !. �',� a� �� Zip Code O609>i
Location of proposed work
Describe fully nature of permit requested
S!ati ng dale ` �"< Approx. time Jor completion
Ca!! Before You Dig No. Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, IN(5LUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR,
Snow sketch of proposed work or furnish This s2clion to be filled out by
!wo copies of separate drawing Indicate North ,TQwn of S,�outh Wlndsor
No. cuts
Est. Patch Size(s) sf
Est. Pvt. Thickness in.
Est, Patch Unit Price$ fsf
Est, Patch Cost S
Est, Curb Replacement It
q �.a Est. Curb Unit Price$ /It
Est. Curb Cost$
Est. Traffic Unit Cost$ fhr
Est. Traffic Control $
Amt. of Deposit S
__� Total Due S
( )Cash O Check#
Appi,cant is responsible for contacting Paid By
the Ponce Dept. and C.B.Y.D.
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
CONrvECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERM] UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL,
Stgneo Date:
.:,,e G�� �����<. 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
:aeet Excavation Permit 08 REV 10.22.08