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HomeMy WebLinkAboutStreet Cut Permits 123 Northview Drive (2) 1500120 PERMIT NUMBER DATE: 06/22/2015 TOWN OwN OF S O U T H WINDS GIS ID: 6450o123 STREET CUT O R, C T MUNIS APPLICATION# 201500767 PENT NAME: APPLICANT EWPIRATION D FEE: ADDRESS. QUALITY PAVING ATE: 25.00 194 S. MAIN STREET. 06/21/2016 EAST WINDSOR, CT 06088_ ADD LOCATION I23 NO i LOC�AT PHONE OWNER:,' THVIEW DRIVE 860-523_4182 -NOVAK 'BTER M 123 N©Rfi WORK DESCRIPTION: SOIT DRIVE DRIvp Y H 1NDSOR, CT 06074 APPLICANT AGREES TO THE TO FURNISH THE T OF CONNECTION SOUTH SI�DSOR FOR AN ENSOU TH WINDSOR FOR PE WITH T ESP THE RMITS AS OUTLINED�TT AND THE SES INC AMOUNT OF APPLICANT ISDBYTHETO BODREQUIRED /� H�O�OF SOUTH WIND ILIAR WITH AND WIR AND AI REIMBURSE c.v / MAINTENANCE OR REPAIR R'S ST ET CUT I'E ABIDE BY THE RULES AND WORK IN ISSUED BY RMITMANUAL REGULATIONS 6i22i20I5 2:33 PM DATE INS ECTED *** PERMIT TO BE KEPTON INSPECTED BY - AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO:; CONTRACTOR:_ ya jo A / 4 LOCATION: 1 ,93 l� TYPE OF WORK: -;,,) DATE INSP NEEDED: DATE INSP: /7A� INSPECTED BY: $ WORK IN PROGRESS: m -�--e_ t�9 ct, SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: " " DATE: r� S/molloy/forms 2014 Town of South Windsor INPSECTION 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 $25.00 Name of Firm l ; �, �,, Z 3 Phone No. —5 � Address of Firm 37 Zip Code Location of proposed work Ole— Describe fully nature of permit requested Starting date >z� /�� _ Approx.time for completion_ ' ? Call Before You Dig No. N 2_ -5 Existing Water Supply: ❑Public Wcfer ❑Well Existing Sewage Service: ❑ Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH 1S TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. -Show sketch of proposed work o mish two copies of separate dra 'ng This section to be filled out by Indicate.North Town of South Windsor No.cuts Est.Patch Size(s) sf Est. Pvt.Thickness in. Est.Patch Unit Price$ /sf Est.Patch Cost$ Est.Curb Replacement ft �r r >` ,f Est.Curb Unit Price$ /ft 1,71 Est.Curb Cost$ Est.Traffic Unit Cost$ /hr Est.Traffic Control$ L Amt.of Deposit$ Total Due$ ( )Cash O Check# _ Applicant is responsible for contacting S Paid By the Police Dept.and C.B.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 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 MANUAL. Signed: Date:_ Title:_��" Ce —� Driver's License#: 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