HomeMy WebLinkAboutStreet Cut Permits 33 Fox Hill Road (2) ------------------------------------------------------ --
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1400232 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/31/2014
GIS ID: 33900033 FEE: 25.00
MUNIS APPLICATION# 201401054 -= EXPIRATION DATE: 07/31/2015
APPLICAI LOCATION
NAME: AIROLDI'S INC. „ ADDRESS 330 HILL ROAD
ADDRESS: P O BOX 71 ff 113R KUZEMCHAK JOYCE E
SOUTH WINDSORyg 661- = 3 SHILL ROAD
-�SOUFH VINDSOR,CT 06074
PHONE =
Al
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WORK DESCRIPTION: DRI[VWmAY „=
APPLICANT AGREES TO FURNISH THI;TOWN OF SOUTH WII�II�S(1R THE`AMOUNT 9F IflND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIIYPENF,S INCURREDBY THE TOWII FOIIvIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR W1H AIkII3 WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN bF§6-UTH WINDS 'S S REI T UT-PF MIT MANUAL.
ISSUED BY DAlt INSPECTED INSPECTED BY
7/31/N141:541'M *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 619 CONTRACTOR:
LOCATION: 3 3 RD y \� f7ctn.Q
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: l
Ak
INSPECTED BY: �
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L, DATE:
S/2014 Town of South Windsor INPSECTION REPORT 14
`x1`` i.u1rG Y1yre�rtd�Xy+ t r�' sp i t r`g a 1C :... d wpxv� .sr'�,' t �. N '•'x
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 •'�o ` 5 ��'� • Phone No. , $�
:.ogress of Firm Q o r `1 �o�� !. �' �� Zip Code 06o�i}
_ovation of proposed work
Describe fully nature of permit requested
,
S:aning date ` `1 3� \' Approx. lime for completion
Ca : Beiore You Dig No.` Existing Water Supply: ❑ Public Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, IN6LUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH, TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Snow sketch of proposed work or furnish This s2ctl2n to be filled out by
fw0 copies of separate drawing Indicate North Town of §outh Windsor
No. cuts
Est. Patch Size(s) sf
Est. Pvt. Thickness in.
Est. Patch Unit Price$ rsl
6a g Est. Patch Cost $
Est. Curb Replacement It
Est. Curb Unit Price $-/It
Est. Curb Cost $
►� Est. Traffic Unit Cost$ rh(
Est.Traffic Control $
Amt. of Deposit $
Total Due$
( ) Cash ( ) Check#
Applicant is responsible for contacting Paid By
:ne 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
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
FERMI uTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
S,gnea Dale:
-;i;e GL� ��M��- 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
:;"re: Excavaaon Permit 08 REV 10.22.08