HomeMy WebLinkAboutStreet Cut Permits 57 Perrin Lane (2) 1500212 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/18/2015
GIS ID: 70900057 FEE: 25.00
MUNIS APPLICATION# 201501294 EXPIRATION DATE: 09/17/2016
APPLICANT -LOCATION
NAME: CENTRAL SEALING CO INC ADDRESS: 57 PER$II--LANE
ADDRESS: 150 SUNSET RIDGE DRIVE OWNER: RILEY!kA�TCE M&KEVIN M
EAST HARTFORD, CT 06108 57 PIµRRIN LA
SOUTH WINDSOR,CT 06074
PHONE 860-289-7900
WORK DESCRIPTION: DRIVEWAY
THE DRAIN LAYER ASSIGNED TO THIS PERMIT HAS A VALID LICENSE ISSUED BY THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH`IN THE ATTACHED`CONDITIONS'. ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS.
i
ISSUED BY DATE INSPECTED INSPECTED BY
9/18/2015 10:44 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO-4 CONTRACTOR: (fe r)-rC41 S' l i✓�9
LOCATION: 5 7 PLC 2) A) nP
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: .2 )xg I i&
INSPECTED BY: &b
WORK IN -
PROGRESS: pol—l-
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: ' l
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 $25.00
Name of Firm o m f -zo seakt to (VlG- Phone No. � �
d Ct-7�a 6
Address of Firm I Slet-�I T Oy i 'T- Zip Code 0 U1 1
Location of proposed work (!cal L-O-Kx-
Describe fully nature of permit requested K�I°Vl, e �l a �t S �( �' I'`)
Starting date l t> Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
XExisting Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
cvml-� 0 Est.Pvt.Thickness in.
(�1 Est. Patch Unit Price
Est.Patch Cost$
� ItpS
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
wC Est.Sidewalk Replacement sf
I f 1 Q S Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
7 6S( � ��1 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 PE I IIT MANUAL. (( ,�
Signed: �"" Print Name �Lti t 1.e 1-e i t 12—T Date: /
Street Excav ' n Permit 2014