HomeMy WebLinkAboutStreet Cut Permits 9999 Avery Street (9) 1500152 TOWN OF SOUTH WINDSOR, CT
PENT NUMBER STREET CUT PERMIT
DATE: 07/21/2015
GIS ID: 06309999 FEE: 0.00
MUNIS APPLICATION# 201500952 EXPIRATION DATE: 07/20/2016
APPLICANT LOCATION
NAME: BARBER UTILITIES LLC ADDRESS: AVERY STREET
ADDRESS: 35 PINNACLE ROAD - - OWNER: TOWN O SOUTH WINDSOR
ELLINGTON, CT OWN 1540 8UL-IVAN AVE
SOUTH WINDSOR, CT 06074
PHONE
WORK DESCRIPTION: WATER TIE IN(SOUTH CORNER OF INTERS
ECTIONO GRAY AND AVERY)
AVERY STREET PROJECT 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.
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ISSUED BY DATE E INSPECTED INSPECTED BY
7/2 1/201 5 9:32AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:; J S 00 CONTRACTOR: or tl4j / ii I s
LOCATION: Sovi`71, r�) �►�Pc ire r ser+ljz n 0 ,�' ✓� a �1f' I y
TYPE OF WORK: 14Ja v' l e 5�- �'✓�a,,o�(-
DATE INSP NEEDED: ._r S-t 5 DATE INSP: 10 ZS-16
INSPECTED BY: JJ F
WORK IN
PROGRESS: Wol -
- I -:fAAD :.Aa4 C471LA EX.XLI&;6k, e,j6c-r , 94- WAI-T ' ,MGM rD
SEPTIC TANK PUMPED, SMASHED, FILLED AJja WITNESSED ❑ YES ❑ NO
AS-BUILT: N/
INPUT:_ Lam- DATE:_I
S/molloy/forms 2014 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 1640 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm Phone No. gm�_wj
Address of Firm Zip Code
Location of proposed work
Describe fully nature of permit req ested
Start!ng da#e Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut 04 Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
11 Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
-Water Supply: 9 Public Water ❑ Well Sewage Service: ❑ Public Sewer Cl Septic
Shaw sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No,cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
L Est. Curb Replacement ft
Est.Curb Unit Price$ fft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Tit lK Est.Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ Ihr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash { ) Check#
Applicant is responsible for contacting the Police Dept:and C.B.Y.D
PERMIT SHALL BE KEPT ON JOSSITE 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 FORANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT E AM FAMILIAR WITH AND WILL ABIDE:BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'$STREET CUT PERMIT MANUAL.
Signed: _____ Print Name , __ ___,_ Date;