HomeMy WebLinkAboutStreet Cut Permits 239 Oak Street (3) 1400351 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 12/23/2014
GIS ID: 65400239 FEE: 0.00
MUNIS APPLICATION# 201401821 PIRATION DATE:
-4 A I
'`r
APPLICAN .{ f LOCATION
NAME: CONNECTICUT WATER COIfI,A1q A A STREET
ADDRESS: 25 NORTH ROAD ; t A, S WARD E&SUZANNE S
1.
EAST WINDSOR,CT BFr STREET
INDSOR, CT 06074
PHONE 860-623-3355
WORK DESCRIPTION: REP f.r � f WORKING IN GRASS
ON 9
APPLICANT AGREES TO FURNISH THE - y` _ 'F. D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR T TENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND ¢ 'ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WN1�11N1r? ..` IT MANUAL.
� -'0
ISSUED BY D � IN�W D INSPECTED BY
12/23/2014 9:43 AM PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
i
tea,
IK
t� xa�
TAk
3# ors
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l nh' I CONTRACTOR; �.
LOCATION: _I)a
TYPE OF WORK: ?
DATE INSP.NEEDED: DATE INSP: ala&1 r.5
INSPECTED BY: �
WORK IN
PROGRESS: A :S X 5r ckk 'nt Le h
- . .1 VA A4
T
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: `
S/moilay/forms 2014 Town of South Windsor YNPSECtION 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 .f I=i Phone No. ::ft:�.ZQZ 2:.8�
Address oflrm S Klrit� t ,aA zlp Code; C�60 ,,8
Location of proposed Yifo#�_ _ ,
Describe fully nature of " ii f'',E tt t iCt. I� �I ,Aci �.ili'rA k�ltle•.. �tN. .S t`E. ► _ Zy Z. _
c)rtk Sr. r tila �- IN arA35 oN
..
Starting date I Z(rir► fw Cap Before You Dig No -- Zo:14 51007$$
PLEASE NOTE: THE.DEPOSIT FOR THE.PERMANENT PAVEMENT PATCH AND CUFIB:REPLACEMENT IS A PRELIMINARY.ESTIMATE. THE
APPLICANT 1S RESPONSIBLE FORTHE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDINGANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
.Qhq.:k Applicable: L"No Pavement,Curb.or Sidewalk Cut ❑ Pave...men.:tCut. ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway-Widening ❑ Proposed New Driveway
Water Supply: G?Public Water ❑ W0111 Sewage Service: ❑ Public:Sewer ❑ Septic
Show sketch of os
roed work or furnish
P.,_.p.__ Indicate North Thssec't[ori�to6e.fllted.oulbtrTolvrai
two.copies of s8 tatiadrawing
No..cuts
Est. Patch Sizes} sf
''` Est Pvt.Thickness
Est.Patch Unit
Pnce';$ •;•_t#;
Est.Patch Gost;$
Est.Curb Replacement
Est.Curb Unit Price$ /ft
3 + Est.Curb Cost$
Est.Sidewalk Replacement sf
� S Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost.$
: Est.Traffic.Hours .... ..... —.. .:.:....:.:'_.::.....h.r
r
D�K
Est.Traffic'Unit Cost$Tv
..........:.:::..::......_r..,,:... ...............
P 1idi. ..:.: :..::r=st.Traffic Control$
A... Depo •
mt of Deposit$
=::. :-...:....:. ..:...:.:..: : . Total Due": ::
:...........:.......:: .:':..: :.
I, ash ( Check#:
Applicant is responsible for contacting ttie Police:Dept.and C:B.Y.D
PERMITZHALL BE KEPT ON JOBSITE'AT ALL TIMES Paid By,.,-
I A.GREE,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 i4M FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDS STREET CUT PERMIT MANUAL.
Signed: :„ "�,"^,..�... Print Name.... /Aid C::::.ej.c awl./
Date;•:
Street Excavation Permit 2014 "