HomeMy WebLinkAboutStreet Cut Permits 9999 Avery Street (8) 1600021 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/01/2016
GIS ID: 99990630
MUNIS APPLICATION# 201600343 FEE: 0.00
EXPIRATION DATE: 04/01/2017
APPLICANT LOCATION
NAME: R&D UTILITY CONSTRUCTION INC ADDRESS: 9999 AVERY STREET
ADDRESS: P O BOX 708 OWNER: TOWN OF SOUTH WINDSOR
STEVENSON,CT 06491 1540 SULLIVAN AVE
PHONE
S WINDSOR, CT 060742734
WORK DESCRIPTION: RELOCATE FRONTIER COMM FOR TOWN PROJECT
AVERY&WOODLAND NO FEE
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.
3 �
ISSUED BY DATE INSPECTED PECTED BY
4/1/2016 12:39 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
, r
PERMIT NO o? CONTRACTOR: V
LOCATION: I
TYPE OF WORK: D D J?rl�ll ec
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: , F'
WORK IN
PROGRESS: l��?-k- Cc��Gt,FTFiD
SEPTIC TANK PUMPED, SMASHED, FILLE WITNESSED ❑ YES ❑ NO
AS-BUILT: _ I j/-A,
INPUT: j DATE:
s/molloy/forms 2o14 Town of south Windsor INPSECrION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT �' � I
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
' TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT�0S6074 FEE $25.00
Name of Firm T' o� � Phone No.,9V 3 c2 0 ~7/ ;, 7
Address of Firm S- 718 MOO W5 - Zip Code
-19
Location of proposed work AyQ{-t S'% (4� LUGYjnIA�,� h/ .
Describe fully nature of permit requested Bl? Ioc A�-c_ Vrotiv"TI ee n,n -jc'--p y
Iv'c 1a- L- d
Starting dat L/I d/ /G Call Before You Dig No (2
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s)� sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /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'S ST EET CUr PER T MANUAL.
Signed: Print Name VrU w6wb6 Dater 1 /
Street E a ion Permit 2014 '/�