HomeMy WebLinkAboutStreet Cut Permits 9999 Clark Street (7) 1600156 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/11/2016
GIS ID:20409999
MUNIS APPLICATION# 201601108 FEE: 25.00
EXPIRATION DATE: 08/I 1/2017/2017
APPLICANT LOCATION
NAME: SIMSCROFT ECHO FARMS ADDRESS: CLARK STREET
ADDRESS: P O BOX 581 OWNER: SOUTHWINDSOR TOWN OF
SIMSBURY, CT 06070 1540"SULLIVAN AVE
SOUTH WINDSOR,CT 06074
PHONE 860-651-0231
WORK DESCRIPTION: STREET EXCAVATION FOR WATER TIE IN
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'S STREET CUT PERMIT MANUAL.
V ithas
ISSUED BY DATE INSPECTED
INSPECTED BY
8/11/20161:13PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:; 16 O(9/Ss CONTRACTOR:_-5'j
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: ,
WORK IN
PROGRESS: �`►�,s« � �Altc�z w. 3`� X —
Csr
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: 112
S/molioy/forms kuA Town of South Windsor INPSECTION 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 $25.00
Name of Firr71��� macrn - ��1�� F��w, S, 1n�L- . Phone No. C1 (ao) LE I - Q Zj I
Address of Firm Z -1 - rm-s V, c2 \ LT Zip Code t (ao`40
Location of proposed work s 5 Sy - 'hr;
Describe fully nature of permit requested
Starting date - I zoiu Call Before You Dig No 2-oi u .:Z_c�c�
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.__....
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut YO Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Drive;�Public
hanges El Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out bV Town
two copies of separate drawing
No.cuts
-1z— = �'-��—eIlk 0Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
L t `� Est.Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
�` S.rni} _ O ~cam n•�r,:� Est. Sidewalk Replacement sf
0
' J Est.Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Fper�-; �iy
DRIVEWAYS must be 3ft or more from the prope li / Total Due$
section 2.17 of the zoning regulations
O 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 THE OWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT I AM FAMILIAR WITH AND WILL ABIDE BY T E RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S STREET C41T PERMIT MAN L
Signed: Print Name . rV L--��Lj-jjDate: l
Str t Excavation Permit 201
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