HomeMy WebLinkAboutStreet Cut Permits 12 Heatherwood Drive (2) 1500094 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/02/2015 "
GIS ID:41300012 FEE: 25.00
MUNIS APPLICATION# 201500637EXPIRATION DATE: 06/01/2016
APPLICANT LOCATION
NAME: QUALITY PAVING COr 0-
II)�5 12IAIHERWOOD DRIVE
ADDRESS: 194 S.MAIN STREET t�YVN R RI EYE IILY J
EAST WINDSOR, CT 0608E 5 2 194VTf ERWOOD DR
ib
( UTIT WINDSOR, CT 06074
PHONE 860-523-4182 "
WORK DESCRIPTION: DRIVEWAY -
APPLICANT AGREES TO FURNISH THE 1�WN OI#SC�UTIWINDSOR THE AMOUNT DF I�O1D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI'E} ?IPENsES INCJ�RRISBY T TO WPOIIvAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH1PLICAI;IT IS.,Ft1IfIL3AR,WIILAfiIII WILD ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SO UT FLWIND O `S STREET CUT ER1NIfT MANUAL.
ISSUED BY DAPS INSP5ECTED INSPECTED BY
6/2/2015 9:45 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:.: / Gb 9 CONTRACTOR: �I
LOCATION: f 0069al jD j
TYPE OF WORK: ,D n'� zat Q
DATE INSP NEEDED: DATE INSP: l�
INSPECTED BY: i9 f
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: [�IM� DATE: ;2 I
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE /$25.00
Name of Firm Phone No. �3
Address of Firm Zip Code 6
Location of proposed work T
Describe fully nature of permit requested
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Starti g date ot You Dig o z o 1 Z
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT 1S RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /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
d 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 S UTH
WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: zY Print Name Date: -
Street Excavation Permit 2014