HomeMy WebLinkAboutStreet Cut Permits 47 Patria Road (2) 1600073 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 05/25/2016
GIS ID: 69900047 FEE: 0.00
MUNIS APPLICATION# 201600665 EXPIRATION DATE:
APPLICANT 3 N LOCATION
NAME: EVERSOURCE ADDRESS: 47 PATRIA ROAD
ADDRESS: PO BOX 270 OWNER: VALLEY HOLDINGS LLC
HARTFORD,CT 06141 47 PATRIA ROAD
SOUTH WINDSOR, CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: 1'X1'VAC HOLE,TO EXPOSE&RAISE PAVED OVER TEST STATION
APPLICANT AGREES TO FURNISH THE-,-
HE 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.
ISSUEDTrY DATE INSPECTED INSPECTED BY
5/25/2016 12:01 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: CONTRACTOR: Sf) y r
LOCATION: 49 ZA L-Gcp
TYPE OF WORK: 0a, 44-. q-
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 87L
WORK IN
PROGRESS: I eS� S' .C,-11L
SEPTIC TANK PUMPED, SMASHED, FILLED - WITNESSED ❑ YES ❑ NO
AS-BUILT:
,j 1
INPUT: G - "._... DATE: °�44 M
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
'AP
PLICA'"i0 f(7R TREEi`fX
Appl. No. TOWN OF SOUTH WINDSOR
Permit No.
PUBLIC WORKS DEPARTMENT
NUE
o ... :,. SOUTH WINDSOR,CTn06,07.4 .
FEE $25.00
Name of Firm ✓'2YSbl�f '(,Q Phone No. 203`GzPt3-D (D—�'
Address of Firm )2 S \0t T Zip Code $
Location of proposed work
Describe fully nature of permit requested_ ) 'xT K04 oLa Ile
Starting date Approx.time for completion- / da L/1
Call Before You Dig No.201 L,20poa`t'4 Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
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 TEMPORARYPATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or fumish
two copies of separate drawing This sectlon to be filled out by
Indicate North Town of South Windsor
Ste mU P
No.cuts
0
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$./ft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.D.
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 OUTLINE THE TOWN O SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Dater
Title. Driver's License#: 2-1
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08
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The material contained on this map _
shall be considered proprietary to Ti t I e
Eversource Energy and user(which is t
defined as any person or entity 4�J/] .�
who has received the map through • / Nflo-o
EVERS URGE
sale,purchase,exchange,gift,or �
otherwise)shall keep it in confidence
and shall not furnish or disclose it ENERGY
to any third Party without the prior Information shown is not guaranteed and Eversourae Energy assumes no rxsponsblillyy W.—.,"
written permission of Eversource Energy. Contractors are urged to tali Eversource Energy for further information at 1-800-11-0900 Date: _ ay—
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The material contained on this map 1►t
shall d considered proprietary to Title: I� �- 61 1 t,`O O
Eversource Energy and user(which is �-�t EVE RS=U R E
defined as any person or entdy
who has reeerved the mop through
sale,purchase,exchange, gift, or
andoth shall
shall keep it in confidence ENERGY
and shall not furnish or disclose it '
tr,any third party without the prior Information shown is not guaranteed and Evemo—Energy assumes no nsponabilily eC O1"r'y'
written permission of Eversource Energy. Contraotors are urged to wll Eversource Energy for further information at,-800-889—Og00 d g• _ ay_