HomeMy WebLinkAboutStreet Cut Permits 50 Cadbury (3) 1500066 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/07/2015
GIS ID: 15900050 FEE: 25.00
MUNIS APPLICATION# 201500469 EXPIRATION DATE: 05/06/2016
APPLICANT LOCATION
NAME: AIROLDI'S INC. ADDRESS: 50 CADBURY
ADDRESS: P 0 BOX 71 OWNER: BRUNEAU LISA A
SOUTH WINDSOR,CT 06074 50 CADBTRY
SOUTH VWINDSOR, CT 06074
PHONE
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 ANYEXPENSES 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 THETOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
ISSUED BY OATEINSPECTED INSPECTED BY
5/7/2015 9:27 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: '211116
INSPECTED BY: 8
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: Cj DATE:
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date.
SOUTH WINDSOR,CT 06074
FEE $25:00
Name of Firm Phone No.'' "
Address of.Firm C� c dip Code �' O
"Location of proposed work -
Describe.fuJly nattare:of lierinit requested .
Starting date" Approx.time for cbrripleton
Call Before You-Dig No rt� - : Existing Water Supply; []PubllC Water Weil"
Existing Sewage SOWICe: [] Pubii�Sewer ❑Septic
PLEASE NOTE THE 13-POSIT,FOR THE PERMANENT P%1VEM NT RATCI AND CURB FI LAG I� RT`IS A
PRI:LIMINAR1f ESTIMATE THE APRLICANT IS RESPONSIBLE QR THE FULL FINAL COS't�OF THE" .
PE IAt�E " PATCH AID CURT$JREPLrACEMEN�,µ.INCLUDING�I NY INQ"ASES FI�A�TCM A13Eq,CURB.
LETi, C GC3H`T`ROL AND THE TOWN'$CONTRACT COSTS..THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT R COULD BE LATER THAN A YEAR.
Show sketch of proposed"work or furnish This sectidn to be filled out by
two copies of separate drawing Indicate.North Town of South Windsor
No.cuts.
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft.
Est.Curb Cost
I ^ Est.Traffic Unit Cost$ /hr
Est."TM is Control$
Amt.of Oeposit.$
"Ttital
( )Cash { )Check#,
Applicant is responsitAe for contacting _Paid By
the Pol ce.De t ,and C,D.Y.D
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 kM FAMILIAR WITH AND WILL ABIDE I3Y THE'RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN HE 1 OWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL:
Signed: Date. d.
Title: Driver' se
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 Rermit 08 REV 10-22-08