HomeMy WebLinkAboutStreet Cut Permits 9999 Clark Street (6) 1600155 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/11/2016
GIS ID:20409999 FEE: 25.00
MUNIS APPLICATION# 201601107 %XPIRATION DATE: 08/11/2017
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APPLICANT f LOCATION
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NAME: SIMSCROFT ECHO FARMS AI7IRESSAR STREET
ADDRESS: P O BOX 581 . :,.ti OWNER> S;OUTIjWINDSOR TOWN OF
SIMSBURY,CT 060.70y" ;;.:< 154ff' ULLIVAN AVE
4 t iTHVINDSOR,CT 06074
PHONE 860-651-0231
WORKDESCRIPTION: STI�EFi�x��CA�ATI�3I+I POR.SANII`ATLY,SP�ti�R TI.E 114
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APPLICANT AGREES TO FURNISH THTOWN tFLO DSQRAR
IE`1MQTJNTS01'$SAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY P):IaiSES INl.IiwJ93Y TF E T6 F 1 I1%IAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND PEPLIt; NT IS PAMII TAR GC?i H ANp UJI1 L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSO 'STR11;T DUI T'$RIVIIT MANUAL.
ISSUED BY DATE SPECTED INSPECTED BY
-9/11/20161:11PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES"**
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: l OD/tom CONTRACTOR: c re
LOCATION: C
TYPE OF WORK: C UJP
DATE INSP NEEDED: DATE INSP: :'
INSPECTED BY: c,,,)�
WORK IN
PROGRESS:
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SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT:. �.L .�' -,:_ DATE: I^ CH U
S/motfoy/forms 2014 Town of South Windsor INPSECRON REPORY 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 $25.00
Name of Firm rnnic-m—U- t sx,-s. _Ln Phone No. t 9SLp4 L.&!1-Oz,31
Address of Firm Z V.LL�zD�� t '",'. �.� � �7' Zip Code o'40
Location of proposed work �-
Describe fully nature of permit requested
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Startingdate .i,-sl-. zolu _ Call Before You Dig No o
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.a __....
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: 63/Public Water ❑ Well Sewage Service: ❑ Public Sewer Cl Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
'y Est. Patch Unit Price$ Isf
I Liz Est.Patch Cost$
.. Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
i
Est.Sidewalk Replacement sf
y Est.Sidewalk Unit Price
w ~✓ r— Est.Sidewalk Cost$
Est.Traffic Hours hr
t/ Nti�l Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
t
DRIVEWAYS must be 3ft or more from;he property line per Total Due$
section 2.17 of the zoning regulations
( )Cash ( )Check#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
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 TH OWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT I AM FAMILIAR WITH AND WILL ABIDE BY HE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S STREET T P ER IT MANUAL. —~ J {
Sign Print Nam M '"lu-.-S-t)�e ti Date: �" Ice
Stre t Excavation Permit 20 r `