HomeMy WebLinkAboutStreet Cut Permits 9999 Foster Street (5) 1200213 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 11/05/12
GIS ID:33609999 0FEE: 00.00
MUNIS APPLICATION# 201201437 ,, IRATION DATE: 11/05/13
APPLICANT _ g, z l
{' t .: 4 F: LOCATION
NAME: NEW ENGLAND CON TE STREET
ADDRESS: 92 MOODY STREET WN SOUTH WINDSOR
P O BOX 317 *.- AVE
LUDLOW,MA 01056 <, ,. J SOR,CT 06074
PHONE
WORK DESCRIPTION: FUN R S �.
BO SNia= ` I L R
APPLICANT AGREES TO FURNISH THE ti.SO ay E O ' REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR 9 � " "
CONNECTION WITH THIS PERMIT AND T '� -I �. � � �:�> ��" ," F"` � ..OR�IvL� TENANCE OR REPAIR WORK IN
T ABIDE BY THE RULES AND REGULATIONS
FOR PERMITOUTLINED IN THE
TOWN O �H T F a a MANUAL.
ISSUED BY D INSPECTED BY
11/5/2012 9:21 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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z F?.LEASE7AE ow, ,AEA IWO.,WORKING DA S r F3TER AP L.1_C ►Ti N FOR ISSUANCE OF PERMIT; _ ,
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WORK?t+eAYNQT�BEGIId UNTIL3A PERMIT HAS B6E IJ ISSUED k __ _ # � �, L nY ;
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PRMi SHALL BED EPT ON`JOBSITB AT ALL TIMES `� f >
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aolaolVaZ APPLICATION FOR STREET EXCAVATION PERMIT ,12,005,/3
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
` PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date: 16 L2 11
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm ���tv l✓ Lv4 Cle 1%r-t+-Z _ leIAi c 0 LPhone No.
Address of Firm a ':-n4yClr4,1Skel Zip Code 016E 6
Location of proposed work 'W 5Y'e0- 5� S c n
Describe fully nature of permit requested V'kl�t t. e k j(fivl ei 'yt jrcle-
Starting date I IZ-q I Approx.time for completion
Call Before You Dig No. 0-01Z._�307-13f7 Existing Water Supply: Public Water ❑Well
Existing Sewage Service: Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR.THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Show sketch'of proposed work or furnish This section to be filled out by
two copies of separate drawing : Indicate.North Town.of Sbuth Windsor
ecTNo.cuts
Est.Patch Sizes) sf
[( 'v °V t e Ov - �i°� 5° Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft_
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit90
$
W iv ad Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.D.
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
C.ONNE.,TION WITH THIS PERMIT AND THAT.I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS O. TLINED 1 THE TOWN OF SOUTH WINDSOR'S STREET CUT PER tI�T tpNUAL.
Signed: _ Date:
Title: ` 8` z'' �'' f 't Driver's License#: MA S6 70 9�Z�
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APOLICA'TiON FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08