HomeMy WebLinkAboutStreet Cut Permits 22 Clover Drive (2) 1500159 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 07/23/2015
GIS ID: 21600022
MUNIS APPLICATION# 201500978 FEE: 25.00
EXPIRATION DATE: 07/22/2016
APPLICANT.-' LOCATION
NAME: TELE-NETWORKS ADI)REiS: 22 CLOVER DRIVE
ADDRESS: 31 BAKEWELL COURT ` OWNER: MALOA GREGORY N&ANN E
CRASTON,RI 02921 22 GLpVER DRIVE
PHONE 401-461-8420 SOUTH WINDSOR, CT 06074
WORK DESCRIPTION: REPLACE EXISTING CATV /
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 WILI�_ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
7/23/2015 12:49 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: 1,Sr CONTRACTOR: _ AAO Y S
LOCATION:
TYPE OF WORK: K/4'�
v
DATE INSP NEEDED: DATE INSP: t L! 1 e
INSPECTED BY: 2 o
WORK IN
PROGRESS: J x e Sr
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT• DATE: f ��
S/molloy/forms 2014 Town of South Windsor INPSEMON 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 $25.00
Name of Firm 7ele-Ald-C')OCICS Phone No, [9 9c?" M J-3aa
Address of Firm 31 i3cLkeLefl C} fryu,5. Al Zip Code 0:4 0191
Location of proposed work I CSC uAf- Dr
Describe fully nature of permit requested lea/acJe
Starting date 7 `A 2 -a olS Call Before You Dig No C) Yo
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /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
WINDSOR' STREET C PERMIT MANUAL.
Signe c Print Name �r` �> V� Date: 7- �,40i S
Str t javati n Permit 2014
60 48
V _____-
ER DR CL
v?5_9
22
42' 34
—1.500p3_----:�......... R2
�V__...�01 K CL OVER DR
SOOP31 320' 12
OP -------- 2
3
R2io-6 ---------------
P3 _::I�...... IREPLACE 463'U/G FEEDER
'50OP3
X0\IER DR ....... .. ........ 3E
.......... 3 R2
.... 2o
--------------
9
WEl 08
dB/R
19
R?Gb 35
371
R
P
25
FG6
36
04 CY)
C) C)
C�
of a C) Cl)
Lu
to
15
35 1
110,
iM z
RG
R111
� Cn ' I
24 C)o
0 0 e i f� f �_o
�.JJR2 70,
- 10
o
U_ R I
E1007