HomeMy WebLinkAboutStreet Cut Permits 12 Clover Drive (3) 1500138 TOWN OF SOUTH WINDSOR, CT
PENT NUMBER STREET CUT PERMIT
DATE: 07/16/2015
GIS ID:21600012 FEE: 25.00
MUNIS APPLICATION# 201500921 EXPIRATION DATE: 07/15/2016
APPLICANT; LOCATION
NAME: CENTRAL SEALING CO INC ADDRESS: 12 CLO ER DRIVE
ADDRESS: 150 SUNSET RIDGE I3RIVE OWNER: FEHER ROBERT&KELLY S
EAST HARTFORD, CT 06108 12 CLOVER DRIVE
SOUTH WINDSOR, CT 06074
PHONE 860-289-7900
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 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 WINDSOR'S STREET CUT PERMIT MANUAL.
c. Yv-0l1 ® 1CQ
ISSUE Y A E INSPECTED INSPECTED BY
7/16/2015 11:22 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.; 1S'6 13 ' CONTRACTOR: CeAff-aJ Seahiaa Cd
LOCATION: ► ,- elase2 i)r'iQe
TYPE OF WORK: Df %\Je I
DATE INSP NEEDED: DATE INSP: Q,21 1,t�
INSPECTED BY: t
WORK IN
PROGRESS: 4. s I 7cc
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [-] NO
AS-BUILT:
INPUT: " DATE:
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm C �Ah-( 191Aj 1K4 (10 1 K C_ P one No. Islud 0391q_711®0
Address of Firm S7 SLk vi sC -D-n ve t e S CT- Zip Code 1)LP
Location of proposed work 1 0v V r I'VC
Describe fully nature of permit re nested oy- Gl 1( Wce Ar tve.LL)&Lj
LAJ l V'j t L14 6V vV Sim
Starting date Call Before You Dig No 061 0 d r7 3
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes V Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Sizes) sf
Zee &' ' "'Cv ,J-e� 0 Est. Pvt.Thickness in.
Est. Patch Unit Price
w �4 nt-p l4 C e dl Est.Patch Cost$
Est.Curb Replacement ft
o dam`i,-e t j / :^%t,_ �Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
T Est.Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.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
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 PEWIT MANUAL. �(
Signed: C Print Name a 11'e I-Q rl 1 iz�! Date: ( �
Street Excavatid Permit 2014
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