HomeMy WebLinkAboutStreet Cut Permits 88 Edgewood Drive (3) 1500045 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/28/2015
GIS ID:29400088 FEE: 25.00
MUNIS APPLICATION# 201500394 EXPIRATION DATE: 04/27/2016
APPLICANT LOCATION
NAME: QUALITY PAVING COSADDRESS: 88 EDGWOOD DRIVE
ADDRESS: 194 S.MAIN STREET OWNER: VIKLINETZ MARK A&KAREN P
EAST WINDSOR,CT 06088 88 EDGEWOOD DRIVE
SOUTH WINDSOR, CT 06074
PHONE 860-523-4182
WORK DESCRIPTION: DRIVEWAY
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 SOUWDE
STREET CUT PERMIT MANUAL.
ISSUED BY PECTED INSPECTED BY
4/28/2015 8:54 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.; yY CONTRACTOR:
p '
LOCATION: el Lk)d 0 CkI� iOle
TYPE OF WORK:
DATE INSP.NEEDED: DATE INSP:
INSPECTED BY: _�
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, PILLED WITNESSED 0 YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/moiloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
'APP-LIGATION.FOR STREET'EXCAVATION PERMIT
:Appl. NO. TOWN OF SOUTM WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
T D R T 06074
SOU H WIN SO C
:'FEE`. 25.00
Name,of Firm >" ten .f Phone No._ �10 Z 3 (
Address of l=trm Zip
' nof o s
w
tro ed
Lora pr po
Describa fully nature.of..permit requested
a, r
Starting date "Approx.pme for completton + a_r_9,d_
F CAII Before You C�;No: Existing Water Supply: []Public Water ❑Well
Exis
#rig Sewage Service -. j]Public Sewer ❑Septic
yPLI ASE NOTE: Ti!I :DEPOSIT FORE PERMANtNT PAvemENT PATCH-AND.-CUR6 REPLACEMENT IS A
`PRELIMINARY E lMA`L'THE APPLICANT:IS:RESPONSIBLE FOR THE 1FULL�FINAL COST,OF THE .
IPERMANENT PAT"ANY CURS REPLACEMENT;INCLUDING ANY INCREASI?S IN PATCH AREA;CURB
'CeNOTH,TRAEFIC"NTROL AND THE TOWNS,t,PPMACT COSTS. THE PF,RMANENT PATCH IS TYPICALLY
_COMPLETED:WITHIf ;p YEAR OF THE TEMPORARY.�PATCH BUT it COULD�BE"LATER THAN 1tl-YEAR.
Show sketch of proposed work or funUsh to be: led outb
two copies of separate drawing Indicate.Northwn.o
" No.cuts
Est.Patch Sizes) sf
Est.Pvt.Thickness in:
l { Est.Patch Unit Price$ . ./sf
Est.Patch Casts
{l Est.Curb Replacement ft
Est.Curb Unit Price s /ft
Est.Curb Costs
F , Est.Traffic Unit costs Ihr
Est:Traffic Control s
. Amt.of Deposit s
r, Total Due s
r ( )Cash { )'Check#
Applicant is res risible forntadi Paid By .
the Police-De t.and OAY:D. _
AGREE TO FURNISH TO,THETTOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE,THE
TOWN 00 SOUTH WINDSOR.FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CUIJNECTION,WITH THIS;'PI=RNIIT AND:THAT I Alai FAMILIAR VYiTH ACID WII1 A we 6Y THE F UM,SS.AND REGULATION8 FOR.
PERMITS AS OUTLINED I THE TOWN OF SOU `H W1 NDSORTS STREET Out PEFIMIT MANl1Al..
.10
0
All
Signed: Date. 1 ZZ��
Title:. » ��-iri .� � 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 JOSSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08