HomeMy WebLinkAboutStreet Cut Permits 221 Fairview Drive (2) 1500146 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/16/2015
GIS ID: 31500221 FEE: 25.00
MUNIS APPLICATION# 201500932 EXPIRATION DATE: 07/15/2016
APPLICANT LOCATION
NAME: AIROLDI'S INC. ADDRESS: 221 FAIkVIEW DRIVE
ADDRESS: P O BOX 71 OWNER: ROBINSON ANDREW T&KERYL Y
SOUTH WINDSOR,CT fl6074 221 -Al----VIEW DRIVE
SOUTH WINDSOR,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 ANY EXPENSES INCURRED BY THE TOWN FORM_AINTENANCE 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 THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
CJ v / 3
ISSUED B DATE INSPECTED INSPECTED BY
7/16/2015 2:19 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:;_/-5-(W CONTRACTOR:
LOCATION: it y I'E'LJ
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: 3 /
INSPECTED BY: P 0
WORK IN
PROGRESS: cv2
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT-
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
PL'ICATIO'NTOR STREET-EXCAVATI - IV"PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $ 00
Name of Firm r Ko L S y Phone No.
Address of Firm p'O `3 D11- ~I 1 --S e. W i N O Sort r Zip Code c)6 0 7
Location of proposed work a a/ Z=,�>,��i�� D R. S o. (d) IV r s o 2_... � 0 6 go �z
Describe fully nature of permit requested vb-,
Starting date_ A j212 - 7- Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLA MENT 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 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
VExisting 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 famish Indicate North This section to be filled out by Town
rw
two oopies of separate drawing
arc>: No.cuts
I Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est. Patch Unit Price
3
Est.Patch Cost$
` l Z Est.Curb Replacement ft
Kr
L , Est,Curb Unit Price$ fR
g
ZZ Est.Curb Cost$
Est.Sidewalk Replacement sf
C '?2 Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
L .. Est.Traffic Hours hr
> Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amy.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
1 AGREETo FURNISH TO THE TOWN OF SOUTH WINDS OR R THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH
1NINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
`THAT 1 TAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
1NINDSOR' THE U PERMIT MANUAL. J
Signed: Print Name 13� � 34��qb`kv Date: —7/�
St red Excavation Permit 2014