HomeMy WebLinkAboutStreet Cut Permits 2 Pepperbush Way (2) 1500139 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/16/2015
GIS ID: 70800002 FEE: 25.00
MUNIS APPLICATION# 201500922 EXPIRATION DATE: 07/15/2016
APPLICANT," ; LOCATION
NAME: COLLA CONSTRUCTION CO,INC ADDRESS: 2 PtPPEIZBUSH WAY
ADDRESS: P O BOX 291 OWNER: SLOCUI�A JUDITH M
WINDSOR LOCKS,CT 06-096 2 PEPPERBUSH WAY
SOUTHWINDSOR,CT 06074
PHONE 860-254-5670
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 WINDSO 'S STREET CUT PERMIT MANUAL.
ISSUED BY DA E INSPECTED INSPECTED BY
7/16/2015 11:32 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:; l SOO /`3 g CONTRACTOR:0'_ 61>A COYtS.VOCZion
LOCATION: 0U
TYPE OF WORK: e
DATE INSP NEEDED: DATE INSP: a 3 /A
INSPECTED BY: �
WORK IN
PROGRESS: 0 �
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES
❑ NO
AS-BUILT:
INPUT: C- DATE:
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Pei mit No.
>TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm ( f�/��';- gin 72Z(l C 77G ( }p /-/-C—Phone No.
Address of Firm / ULl /2 W-t-n Lo Zip Code ) d
Location of proposed work Z..4 3
Describe fully nature of permit requested c I ei C'
date '� 'f '/.� Call Before You Dig No
Starting
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIM 0,TE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PA rCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled ut by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
� 201 I Est.Curb Cost$
1 Est.Sidewalk Replacerner It sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
VEst.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 TO NN OF SOUTH
WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THI 3 PERMIT AND
THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
Will SOR'S STR ETC T PERMIT MANUAL.
Signed: L4A .— Print Name t v M C..K�s� Date: "7 J
Street Excavation Pe 2014