HomeMy WebLinkAboutStreet Cut Permits 295 Rye Street (3) 1500108 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 06/16/2015
GIS ID: 78600295 FEE: 0.00
MUNIS APPLICATION# 201500726 EXPIRATION DATE:
APPLICANT, LOCATION
NAME: EVERSOURCE ADDRESS: 295 k-YI STREET
ADDRESS: 112 PROSPECT HILL RD OWNER: ALDI IN
EAST WINDSOR,CT 06088 295 RYE STREET
SOUTH WJNDSOR, CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: EXCAVATING 1'XI'VAC HOLE TO REPLACE TEST=-BOX ON GAS MAIN
APPLICANT AGREES TO FURNISH 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 THE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATE NSPECTED INSPECTED BY
6/16/2015 8:26 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
------------------------------------------------------------------------------------
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: d CONTRACTOR: re
LOCATION: S- �N P
TYPE OF WORK: E'' f �k
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLtCATIW fOR TRf: EECArt ON P.ERM17`.
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
` PUBLIC WORKS DEPARTMENT
_._._... _..._ NU ---- - -Dade:
_... : . SOUTH WINDSOR,CT-W074 . _.
FEE $25.00
Name of Firm Phone No._-2203—S(�•— a-q�
Address of Firm t2 i SOt Zip CodeLLZE.
Location of proposed work S
Describe fully nature of permit requested
Starling date � '
Approx.time for completion
Call Before You Dig No.20i -2WD3210 Existing Water Supply: ❑ Public Wati ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN.A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section o be filled out b
two copies of separate drawing Indicate North Town of South Windsor
See ff
No.cuts
0
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement fit
Est.Curb Unit Price$ /it
Est.Curb Cost$
Est.Traffic Unit Cost$ - /hr
Est.Traffic Control$—
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Pald By
the Police Dept.and C.B.Y.D.
1 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 UTLINED I HE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: tt
_ & Date:
Title: n'r'�J`M ec1 11 1l rxa n 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
Street Excavation Permit 08 REV 10-22-08
1 4�'
P1721
Jot-
�4 P1719
1:500 1"=41.T e3.3•
' The material contained on this map �''!
shall be considered proprietary to Title: Ms 9—
shall Ener and user which is .G ` 11 " t
defined as on),person or entity EVERS�URGE
who has received the mop through r
safe,purchase, exchange, gfft,or
otherwise)sholl keep it in confidence 111 v ENERGY
and shall not furnish or disclose it
to any third party without the prior Information shown is not guaranteed and Evencurce Energy assumes no responsibilib
written permission of Eversource Energy, Contractors are urged to toll Eversoume Energy for further Information at 1-800-989-0900 Q e: — un—
_V-�
P1721
t •J���1� 6„ MW Np R� �D S� .
S, �q.� P1719
1:500 P-41.T DJ.Y
The material contained on this map Title: �
shall be considered proprietary to
Eversource Energy and user(which is
defined as any person or entity �(/ /'K�
who has received the map through t ` p •�A 1�./l �r�/ w E 1 _U R E
sole,purchase, exchange, gift, or JNI,.J+VIJ
.the shall keep It in confidence ENERGY
and shall not furnish or disclose it eG...r.
to any third party without the prior Information guaranteedose
foration shown is not and Evemource Energy ume res e no ponaiblib
written permission of Eversource Energy. Contractors are urged to call Eversource Energy for further Information at 1-800-989-09�0 a e: — unUlb
—