HomeMy WebLinkAboutStreet Cut Permits 47 Ferry Lane (2) 1500102 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 06/02/2015
GIS ID: 32700047 - " FEE: 0.00
MUNIS APPLICATION# 201500650 E 'IRATION DATE:
APPLICANT - LOCATION
NAME: EVERSOURCE AIST�IES3:, 4 7ERR 'LANE
ADDRESS: 112 PROSPECT HILL R } - dWNERTYR CYNTHIA M&
EAST WINDSOR, CT 136I18 - #FI3YLN
SdUTH WNDSOR,CT 06074
PHONE 860-292-2242 -
WORK DESCRIPTION: INSTALLING NEW TEST STATION d-- GASIvIAINW I TNG IN GRASS
2015 C 007i -
APPLICANT AGREES TO FURNISH THE TO OF SOUTH WINDSOR THE AMOUI�I O BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E�'ENSES-INCURRED 3YTH1 TOWX�FORMAfNTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE=APPLICANT IS FAMII IAR WITH AND,VILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUS H WTNDSOR'S.STREET CUT PERMIT MANUAL.
Ov /
ISSUED BY DATE 1N.P-.I- INSPECTED BY
6/2/2015 2:59 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
---------- -----
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.; %3-®D l4-P- CONTRACTOR:
LOCATION: jaae
TYPE OF WORK: !n.� lli� :. u� �� s*j0f7 90 n
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: A-b
WORK IN
PROGRESS: c "yam
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: i
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPUCA' STREE'i`f-MANATION
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1..540 S--&1 I�AYENI�E Date: —
SOUTH.WINDSOR,C .t1 .74.
FEE $25.00
Name of Firm !veyso ('co- 2 f o Phone No. 2CP-)y5&;0
Address of Firm i t n Svr Zip Code Q O
Location of proposed work Z-r-) 6 a d f r-e-�
Describe fully nature of permit requested I - -
aL t"nGu n V)00�k n V)
S arting date, Le` /5--//- „Approx.time for completion
Call Before You Dig No. /. 23 Existing Water Supply: ❑ Public Wat ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE OF-POSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN.A YEAR-OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish two copies of separate drawing This section to be filled out by
Indicate North Town of South Windsor
No.cuts
0
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit-Price$ /it
Est.Curb Cost$
Est.Traffic Unit Cost$ - /hr
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.
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 OUTLINED I HE TOWN OF S UTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: -� Date:--
Title: Driver's License#__ 2 1 (0
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
47
P25°�9
r
FERRY LA.
"
J ,
"
row
ill �f
O
The material contained on this map LJ � r( (1
shall be considered proprietary to Title:
Eversouroe Energy and user(which is ��
defined as any person orentity EV E RS-U RCE
who has receroed the map through ��
sale,purchase,exchangge,gift,or S 5
ur
otherwlse)shallkeepitin confidence ENERGY
and shall not tumish or disclose it .,,„,
to any all n party without the prior Information shown is not guaranteed and Eversource Energy assumes no respon81WlKy.
written permission of Eversource Energy. Contractors are urged to call Eversource Energy for tuMer Mormation at 1�00�98g-0900 Date:02-Jun-2015
47
P259�g ...........
,
0
FERRY LA. ;
row
U
The material contained on this map ` t�-7 � ( -
shallEver o considered pro tfetary to Title. +T' / l
Ev ned Ice Energy an user(which is
defined as any person or entity E V E RS! R�E.
who has r�weed the map through
I-pura,ase,exchange,gift,or �►1 f 1� "S ENERGY
otherwise)shall keep it m confidence �•'y
and shall not fum.."or disclose it
to any third party withoutthe prior Information shown is notguerenteed and Eversource Energy assumes no responaiWtily. "''°�'"�
written permission of Eversourc.Energy. Contractors are urged to call Eversource energy for further inforrneeon et t-aoasea osoo Date:02-Jun-2015