HomeMy WebLinkAboutStreet Cut Permits 10 Pine Knob Circle (2) 1500114 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/22/2015
GIS ID: 71700010 FEE: 25.00
MUNIS APPLICATION# 201500756 EXPIRATION DATE: 06/21/2016
APPLICANT= LOCATION
NAME: CENTRAL SEALING CO INC ADDRESS: 10 PINENOB CIRCLE
ADDRESS: 150 SUNSET RIDGE DRIVE - OWNER: ANDERSON JAMES R&DIANE M
EAST HARTFORD, CT 061>08 10 PINE NOB CIRCLE
SOUTHINDSOR,CT 06074
PHONE 860-289-7900
WORK DESCRIPTION: DRIV WAY
APPLICANT AGREES TO FURNISH THE "-OF SOUTH WINDSOR THE AMOUNT QF 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 WI1 L 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
6/22/2015 10:05 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO-: �� ®�/ CONTRACTOR:
LOCATION: P/n
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: r�fig
INSPECTED BY: �
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [:] NO
AS-BUILT:
INPUT: DATE: a 1 ^ 1
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
_ ... .�. ._ .v. _ -:--T EXC AVATION'PERM1
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm t(^ 6 lL ? 2 L S C'/�G/n- Phone No.Se o d p9 2100
Address of Firm / Y O ,Svx-S-�? &W ee_ 0 �z Zip Code
.Location of proposed work 10 "'0// 1/LG d
Describe fully nature of permit requested /?linur- .c .C're&&...
Starting date G ' 2 Z ,� Call Before You Dig No o/f - 2 3 ° y�/9
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH,IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
EN/Existing Driveway,No Changes ! Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
`. Show sketch of proposed work or fumish indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
r a Est.Patch Size(s) sf
Est. Pvt.Thickness in.
- A/�/IsL Est. Patch Unit Price$ /sf
Est.Patch Cost$
U Est.Curb Replacement ft
X .
Est.Curb Unit Price$ fft
Y Est.Curb Cost$
� .
T Est.Sidewalk Replacement sf
I Est.Sidewalk Unit Price$ /sf
4.
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ fir
Est.Traffic Control$
s_ 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
1NtNDSOR 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'S STREET CUT PERMIT UAL.
Signed- ✓ Print Name-AfA d.1/0 G I ow A0,120 D ^ Date:
Street Excavation Permit 2014