HomeMy WebLinkAboutStreet Cut Permits 7 Woodhaven Circle (2) 1600070 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/24/2016 y
GIS ID:96600007 FEE: 25.00
MUNIS APPLICATION# 201600655 n
I XPIRATION DATE: 05/24/2017
APPLICANT "V k
LOCATION
NAME: CENTRAL SEALINCx CO INC . ADDRESS " �7 WOQDHAVEN CIRCLE
ADDRESS: 150 SUNSET RIDGE�tDRX>SIE OWNERERRId?AUL E&BETH R
EAST HARTFORD,C�'0,608 7,V4rI70bHAVEN CIRCLE
is 7 SOUTH WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: DR'IVRSkC
APPLICANT AGREES TO FURNISH THTOVV QFO�PFHt.1INDSOI TIE`AIVI�TINT OF$.`AND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A1±I`I—3XPENSES II IC I RED 3 THE TOWN FOR11i1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TE APPL>CANT'IS ItAMTLIAR VIABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINEP IN THE TOWN OF SOUTH WIND�OR.'S STRI ET CUT.PE MIT MANUAL.
ISSUED 8t BATE 04PP" I ED INSPECTED BY
5/24/2016 9:31 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1609 CONTRACTOR:C,4/�� r _
LOCATION:_ C/ Af --
TYPE OF WORK: t LJ ez
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:_ �
WORK IN
PROGRESS: ;jr; � rG?
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: ; C�
S/molloy/Forms 2014 Town of South Windsor INPSEMON REPORT 14
a
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN BALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm 0'em�y&" Sea- € 00 1 n Phone No. Ree) " l 16 6
Address of Firm f 1�b S H-Ce r v �S�- ' �, (2 Zip Code 10 11 �
Location of proposed work J L C>C,'Gk HGLvlel'1 6-i ,-C'-t, --
Describe fully nature of permit requested he- V ,NC'_ et-kV� (LC146e
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Starting date 1(o Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE, THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. I
i
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New'•;Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ GSeptic
Show sketch of proposed work or furnish Indicate North This section to be�fili®d out by Town
two copies of separate drawing
i
No.cuts
Est.Patch Size(s) Sf
I
Est.Pvt.Thickness i in.
Est.Patch Unit Price!$ /sf
Est.Patch Cost$
f
Est.Curb Replacement ft
Est.Curb Unit Price� /ft
Est.Curb Cost$ i
Est.Sidewalk Replacement sf
)a,/eA f ` Est.Sidewalk Unit Price
UP. S► Est.Sidewalks Cost
Est.Traffic Hours 1 hr
Est.Traffic Unit Cost$ Ihr
Est.Traffic Control
�4 Amt.of Deposit$ f
i
Total Due$ �
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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
1
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 WrrH THIS PERMIT AND
THAT 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S STREET CUT PE I�TI MANUAL 1 r
Signed: PWit
� �U� Print Name L( 11 e 7-etl I Z�' Date:
Street Excavation014