HomeMy WebLinkAboutStreet Cut Permits 9999 Scantic Road (3) 606205 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/09/2016
GIS ID: 80909999 FEE: 0.00
MUNIS APPLICATION# 201600236 EXPIRATION DATE:
APPLICANT LOCATION
NAME: CONNECTICUT WATER COMPANY ADDRESS: 9999 SCANTIC ROAD/JOHN FITCH BLVD
ADDRESS: 25 NORTH ROAD OWNER: TOWN OF SOUTH WINDSOR
EAST WINDSOR, CT 0-0088 1540 SULLIVAN AVE
SOUTH WINDSOR,CT 060742734
PHONE 860-623-3355 '
WORK DESCRIPTION: REPAIWEMERGENCY WATER IN BREAK -
APPLICANT AGREES TO FURNISH TH9 TOWN OF SOUTH-WINDSOWTHE 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 THE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF-SOUTH WINDS
OR'S STREET CUT PERMIT MANUAL.
D `
ISSUED BY DATE INSPECTED INSPECTED BY
3/9/20 1 6 2:49PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 606 ,�Q.! CONTRACTOR: C iklC
LOCATION: S . a vl I c�
TYPE OF WORK: oa 4,e-� ffial n 6AAak-
DATE INSP NEEDED: DATE INSP: ��
INSPECTED BY: e
WORK IN
PROGRESS: ya-2 '
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloy/fonns 2014 Town of South Windsor INPSEMON REPORT 14
r
APPLICATION FOR STREET EXCAVATION PERMIT 606 20S
Appl. No,; TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
I TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm :r/f_ / G—orrrJ
Phone No.• : _ - _oil
Address of Irian`aS h/vcd C.es..� p Code-t26
Location of proposed t tk ^- "o-6k2. � d ►" v , /;, `
Describe fully nature of permit ow
Starting date 3 7--16 Call Before You Diglsi !!�-O r6/000 A'� -
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH 1S
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut avement Cut El Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: POALIblic Water ❑ Well Sewage Service: ❑ Public Sewer ❑' Septic
Show sketch of proposed work or furnish.
two copies of separate drawing Indicate North This section to be filled out by Town
No.cuts
st'Patch Sizes} sf
P Est.Pvt.Thickness_ in.
S C,1 /i�' I i r Est.Patch Unit Price
8
l Est.Patch Cost$
, . Est.Curb Replacement ft
Est.Curb Unit Price
Est.Curb Costs
Est.Sidewalk'Replacement sf
i
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$_-
Est.Traffic Hours --_ hr
Est.Traffic Unit Cost$ lliir'
Est.Traffic Control,$
I
Amt.of Deposit$
Total Due
- 97 �
{ as ( }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 SOUTH
WINDSOR S STREET CUT PERMIT
3_ ,_ - `
,f3 rtfl .�._ ✓r�'� Print Nand' .c4e I 1- 4 Date,- Cate.
- _ _ .— --- -
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Street Excavation Permit 2014
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