HomeMy WebLinkAboutStreet Cut Permits 1550 Sullivan Avenue (2) 1500265 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 11/16/2015
GIS ID: 87301550 FEE: 25.00
MUNIS APPLICATION# 201501664 EXPIRATION DATE: 11/15/2016
APPLICANT LOCATION
NAME: TELE-NETWORKS ADDRESS: 1550 SULLIVAN AVENUE
ADDRESS: 31 BAKEWELL COURT OWNER: SOUTH WINDSOR TOWN OF
CRASTON,RI 02921 1550`SULLIVAN AVE
SOUTH WINDSOR, CT 06074
PHONE 401-461-8420
WORK DESCRIPTION: INSTALL 2 INCH PVC TO BACK OF LIBRARY
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 OUTLINfq
}I,N THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
(oV \ = '
ISSUED AY DATE NSPECTED INSPECTED BY
11/16/2015 3:11 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
-------- - - - - - - - -------- ----- ----- - -
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: nI CONTRACTOR: Yy1 L-I� iae( ,
LOCATION:_ I n J VL0-e'
TYPE OF WORK: t S-U I
DATE INSP NEEDED: DATE INSP: .
INSPECI�D BY: �.
WORK IN
PROGRESS: I,-) -y sg&"
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED [J YES ❑ NO
INPUT: DATE:
S/mollw/forms 2014 Town of South Windmr IIVPSEC m REPORT m
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 11540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00
Name of Firm - O \w 0 F—� Phone No.t'2g 0 t4 2-
Address of Firm ; f;AKeWt C`T CC1163 ►� 12.E Zip CodebZgZ
Location of proposed work 1 s50 SU CLk\j" 414f
Describe fully nature of permit requested d-" ev iC 4-d b 4C K Q f L f ra r'l
Starting date // - /7- 20 I s Call Before You Dig Nod 6 t S y to b "Z1 U 4
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut 2TIPavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
0 Est. Patch Size(s) sf
c -a c Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est. Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
DRIVEWAYS must be 3ft or more from the property line per Total Due$
section 2.17 of the zoning regulations
( )
Applicant is responsible for contacting the Police Dept.and C.B.Y.D Cash ( ) Check#
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-SR STREET CJI�PERMIT MANUAL. ,/�`n
Si 61 � )L- Print Name�M 0 11 WAV&, Date:
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