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HomeMy WebLinkAboutStreet Cut Permits 249 Oak Street (2) 1600173 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 09/13/2016 GIS ID: 65400249 FEE: 0.00 MUNIS APPLICATION# 201601245 EXPIRATION DATE: APPLICANT LOCATION NAME: CONNECTICUT WATER COMPANY ADDRESS: 249=OAK STREET ADDRESS: 25 NORTH ROAD OWNER: CUCUZZA FABIO&CYNTHIA J EAST WINDSOR, CT 06088 249--OAK STREET SOUTH WINDSOR, CT 06074 PHONE 860=623-3355 - WORK DESCRIPTION: EMERGENCY WATER MAIN BREAK REPAIR 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 WINDSOR' STREET CUTPERMIT MANUAL. ISS D B / DATE INSPECTED INSPECTED BY 9/13/2016,8:19AM ** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** - - TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO::J %. CONTRACT©R:� LOCATION:_ TYPE OF WORK: 4 AU AL DATE INSP NEEDED: DATE INSP: V14-11 INSPECTED BY: WORK IN PROGRESS: EJi SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO AS-BUILT: INPUT: DATE: S/mouay/forms 2014 Town of South Windsor INPSEMON 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 $25 00 Name of Firm Phone No. U T - Address of FirttaZS ll.lyrt fi (p..•� a�^ Location of proposed vrk-. e2, Describe fully nature of permit requestedrr✓� c. •-�� ' sr, �,t �c ,- Starting date: - - Call Before You Dig No ZU/i 3bc3 z 7J` I PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: XNo Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut '❑ Sidewalk Cut ❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway W4ter Supply: N5PublJcWqter EI Well Sewage Service:"bile-sewer ❑ Septic Show sketch of proposed work or furnish led a North This section to be filled out by Town two copies of separate drawing # � No.cuts i Est. Patch Slab{ si Est.Pvt.Thickness - in. , ss + Est. Patch Unit Price$ /sf tf Est. Patch Cost$ Est.Curb Replacement ft 4� Est.Curb Unit Price_$ , Est.Curb Cost$: i Est.Sidewalk Replacement sf l Est.Sidewalk Unit Price Est.Sidewalk Cost$ Est.Traffic Hours hr Est.Traffic Unit Cost$ /hr //__ 1 Est.Traffic Control$ �- ff Amt.of Deposit$ Total Due ( )Cash O Check# Applicant is responsible for contacting the Police Dept.and C.B.Y.D PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Pa[I'E3y :[,AGREE Tf3 FURNISH TO HE TOWN OF SO UTH WINDSOR THE AMOtJM OF BE�NE?,.REQtIiRi D Aid1)6rJ RWMdURSE THE TOWN OF SQI T,14 YYINI3SOit.FOI AN V EXPENSESJNCURRHI)BY TIME TOWN FOR k ' rT9NANGE iii REPAIR WORK IN CONNE&ION WITH THIS PERMIT AND T14AT I AM FAMILIAR WITH AND WILL AIDE 9Y"1 l tE'RUt QS AND Ff)=GdiLA ftbkt FOR PERiNfT�At;Ot TfJNEd IN THE TOWN OF SOUTH iND,soi4`s.ST-R£STzurr PEwrr MANUAL, Signed. ..� y*--� Pdnt.Naine A 4. Z .r�ct a Date: Street e(Mvatlon Perrrift 14: a