HomeMy WebLinkAboutStreet Cut Permits 9999 Pleasant Valley (9) 1500260 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 11/06/2015
GIS ID: 72909999
MUNIS APPLICATION# 201501611 FEE: 0.00
EXPIRATION DATE:
APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS: PLEASANT VALLEY ROAD
ADDRESS: 112 PROSPECT HILL RD OWNER: TOWN OF SOUTH WINDSOR
EAST WINDSOR,GT 06088 1540"SULLIVAN AVE
PHONE 860-292-2242 SOUTH WINDSOR,CT 06074
WORK DESCRIPTION: INSTALL GAS MAIN INTO NEW PROJECT SOUTH WINDSOR WOODS
PLEASANT VALLEY AND PEPIN PLACE
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANYEXPENSES 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 TO WN'OF SOUTH WIND OR'S STREET CUT PERMIT MANUAL.
ISSUED BY � � � '���'�
DATE INSPECTED INSPECTED BY
11/6/2015 2:32 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
15, 00000
PERMIT NO:: CONTRACTOR: & ,';�A�S o y�(C G
LOCATION: J,P Q -9-- C Q
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
1cr'�dB r err Nf L.-,) C C
R
SEPTIC TANK PUMPED,SMASHES, FILLED WITNEsssED 0 YES ❑NO
INPUT: h"-- DATE:
S/molW/forms 2014 Town of South Wing WSERON WOU 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:—A-flS)1--
SOUTH WINDSOR,CT 06074
c
FEE $25.00
Name of Firm LVe r so u r'co— Phone No. B&O-2 9 2-2-Zg Z
Address of Firm Q `{ ffi I M K 8,`Ea S4 t A t YA aSOr Zip Code �t'nU8 3
Location of proposed work
Describe fully nature f permit requested +Q CIO-J. i l c�
S arting date_. Approx.time for completion :)- CiaQN
Call Before You Dig No.,,)Q1.-5g LlOQ l 9q Existing Water Supply: ❑Public Wjater ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH;T-Ry4FFIC OONT-ROL--AND-T-HF-.TOWN!S CONT-flACT'-GOSTS: T-HE•PERMANENT PAtGH-IS-TY-PICALLY
COMPLETED WiTHIN,A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR-.
Show sketch of proposed work or furnish This section to be filled out t by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt:Thickness in.
j Est.Patch Unit Price$ /sf
Est.Patch Cost$
i
T h' 9co Est.Curb Replacement ft
" F Est.Curb Unit Price$ /ft
Est.Curb Cost$
Si.L, GAS Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
�} Amt.of Deposit$
3Q Total Due$
i
( )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 MOUTLINED I THE TOWN OF SOUTH WINDSOR'S STREET CUT PE MIT MANUAL.
Si ne
g 0"`'"' Date: C 15 5
Title: �SYytCfi O n Driver's License#:
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