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HomeMy WebLinkAboutStreet Cut Permits 23 Cliffwood Drive (5) 1500103 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 06/08/2015 GIS ID: 21000023 FEE: 0.00 MUNIS APPLICATION# 201500673 EXPIRATION DATE: APPLICANT = LOCATION NAME: EVERSOURCE ADDRESS; 23 CIIFF;VJOOD DRIVE ADDRESS: 112 PROSPECT HILL RL7 " OWNER; ;" ANDERSON WILBUR L&RACHEL L EAST WINDSOR, CT 060883 C1vIFF FOOD DRIVE SOUTH WNDSOR,CT 06074 PHONE 860-292-2242 WORK DESCRIPTION: INSTALL GAS SERVICE,. APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANtEXPENSEN THE TOWN' ORvATNTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THI APPLICANT IS FAMILIAR WITH D AN -WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S ST ET UT PERMIT MANUAL. ISSUED BY DAT9 INSPECTED INSPECTED BY 6/8/2015 2:55 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: IS00y©- CONTRACTOR: 1��'►r�.SG� �� LOCATION: .2 P TYPE OF WORK: (1S`l-I 1 9,eA SVO f V ►L,P DATE INSP NEEDED: DATE INSP: 4`)� xs INSPECTED BY: 6 WORK IN PROGRESS: -e-7 0'ctz..z-�y] " P SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: � DATE: S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14 Appl. No. ,. `•v�l,■v � TOWN OF SOUTH WINDSOR~�iv�� r cnrn�� permit No. PUBLIC WORKS DEPARTMENT 1540 SULLIVAN AVENUE Date: SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm CV 6 Phone No . c7 Address of Firm C ' 1� Zo Code No 083 Location of proposed worts _ ( _r F W ®p .� Describe fully nature of permit requested_ E?C C A YAT-Zr S F j y/C4r Starting 0ate.:�._6 -- —/5 Approx.time for completion-- 40 Cali Before You Dig No.,:?-0!513 a 270? Existing Water Supply: ❑Public Water ❑Well Existing Sewage Service: ❑Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR-THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING.ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC.CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY 'COMPLETED WITHIN-A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch bf proposed work or furnish This section to be filled out by two copies of separate drawing Indicate.North Town.of.ftAh Windsor No.cuts Est.Patch Sizes) sf Est.Pvt.Thickness in. Est.Patch Unit Price$ /sf ` Est.Patch Cost$ Est.Curb Replacement_it Est.Curb Unit Price$ /ft Est.Curb Cost$ Est.Traffic Unit Cost$ Ihr Est:Traffic Control$ Amt.of Deposit$ 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 CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED N THE TOWN OF SOUTH WINDSOR`S STREET CUT PERMIT MANUAL. Signed: b 3 P/S Date: Title:. � p A) S ►if—u N /�,�"e�[ Driver's License M 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 0 110 (IOOMJJIIO CO A ... ................._ � .� .� .............................................................. .. .. ............. .......................... )661 dH 3d 111Z to q A A A The material contained on this map shall be considered proprietary to Title: Eversource Energy and user(which is defined as any person or entity who has received the map through EVERSSS""URCE sale, purchase, exchange,gift, or Information shown is not guaranteed and Eversource Energy offf&wwise)shall keep it in confidence assumes no responsibility. Contractors are urged to call a Sshpll not furnish or disclose it Eversource Energy for further information at 1-800-989-0900 ENERGY to any third party without the prior written perfnission of Eversouce Energy. Plotted:oa-Jun-zoos By:gisewrl