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HomeMy WebLinkAboutStreet Cut Permits 65 Steep Road (2) 1400254 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 08/20/2014 GIS ID: 85500065 FEE: 25.00 MUNIS APPLICATION# 201401148 = IyXPIRATION DATE: 08/20/2015 APPLICANT LOCATION NAME: AIROLDI'S INC. ADDRE 6I1P ROAD ADDRESS: P O BOX 71 OWNER =MORA DONNA F SOUTH WINDSOR,&If6©74 ROAD ©i7TH WNDSOR, CT 06074 PHONE „ y WORK DESCRIPTION: DR E—W APPLICANT AGREES TO FURNISH THEE O�yN OF SOUTH WINDSOR THE AMOUNT OF&JND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRIsD BY THE TOWN F"AINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND TH ,APPi ICANT IS FAMILIAR WITH AhID CULL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TO WN OF SOUTH WII�IDSOR S STREET GUT PItI21�IIT MANUAL. ISSUED BY- DATE IN-SPECT'ED INSPECTED BY 8/20/2014 10:59 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: Ni (Z 0 ` S LOCATION: -. .:Ao TYPE OF WORK: > DATE INSP NEEDED: DATE INSP: INSPECTED BY: 43 D WORK IN PROGRESS: ��'"`� 40 1 Le" SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO AS-BUILT: INPUT: G DATE: S/2014 Town of South Windsor MEMON 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 �� S �+� Phone No. bo 'r��W - 3�`l (c. Address of Firm �- `1\ Sa��\.�' ti�saY , C^\ Zip Code O Lc,)-) L- Location of proposed work Describe fully nature of permit requested y ., gyp\ (\s' Starting date \-., \)A Call Before You Dig No 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: ❑ No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut X Curb Cut ❑ Sidewalk Cut ❑ Existing Driveway, No Changes X 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 No. cuts Est. Patch Size(s) 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 WINDS ET CUT PERMIT MANUAL. \\ \ Signed: Print Name �^�` � �� h Date: 7 �� Street Excavation Permit 2014 Print Map Page 1 of 1 Town of South Windsor n it ore� Geographic Information System (GIS) O ` j Gv � e y Date Printed:8/18/2014 r r N MAP DISCLAIMER-NOTICE OF LIABILITY Approximate Scale: 1 inch=50 feet This map is for assessment purposes only.It is not for legal W E description or conveyances.All information is subject to verification by 50 any user.The Town of South Windsor and its mapping contractors assume no legal responsibility for the information contained herein. Feet S http://southwindsor.mapxpress.net/ags_map/printmap.asp?extentYmin=8703 3 6.550127434... 8/18/2014