HomeMy WebLinkAboutStreet Cut Permits 30 Pheasant Way (2) 1500093 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/02/2015
GIS ID: 71100030 = FEE: 25.00
MUNIS APPLICATION# 201500636 = = EXPIRATION DATE: 06/01/2016
APPLICANT - - ;LOCATION
NAME: AIROLDI'S INC. -" ADDRESS ; 30 9-HEA�ANT WAY
ADDRESS: P O BOX 71 OWNER ,-1 OCK MORDASKY MELANIE K
SOUTH WINDSOR, C67 = 0 PIAS .NT WAY
S0UTf-f-j WNDSOR,CT 06074
PHONE -,
WORK DESCRIPTION: DRIVEWAY -
THE DRAIN LAYER ASSIGNED TO THIS I ERMIT HAS A VALIIJ LLC ISI;ISSUEI?&Y THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH IohE`ATTAC IED CO lf7I I TONS ALL wO K SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS ALIT OSHA REQUII MENTT AND THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
6/2/2015 9:37 AM
----------------------------
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Ids CONTRACTOR: 4 1 ro I c11
LOCATION: 3 o cO Sa U)
TYPE OF WORK: 1`k.\�,p C&)n c
DATE INSP NEEDED: DATE INSP: /6
INSPECTED BY:
WORK IN
PROGRESS: .
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [] NO
AS-BUILT:
01
INPUT: C DATE:
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm \~ a�A' c Phone No.
Address of Firm -� + `1 ��\� �, sue, C ip Code
Location of proposed work
Describe fully nature of permit requested
Starting date 1 ) Call Before You Dig No, ;
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
k INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE Tows CONTRACT COSTS. THE PERMANENT PATCH,IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or fumish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /it
Fast.Curb Cost$
1,4
;. Est.Sidewalk Replace me
\9nt sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
'. Est.Traffic Control$
Amt.of Deposit$
Total Due$
5 O Cash O 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
f 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 AMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR T CUT PERMIT MANUAL.
Signed:_ Print Name Date:
Street Excavation Permit 2014