HomeMy WebLinkAboutStreet Cut Permits 9999 Beelzebub Road (3) 1500151 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/21/2015
GIS ID: 09009999 FEE: 0.00
MUNIS APPLICATION# 201500951 EXPIRATION DATE: 07/20/2016
APPLICANT LOCATION
NAME: BARBER UTILITIES LLC ADDRESS: 99g9 BILZEBUB ROAD
ADDRESS: 35 PINNACLE ROAD OWNER: TOWN 4 SOUTH WINDSOR PUBLIC
ELLINGTON,CT 06029 - 157_BURL ESS ROAD
SOUTH WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: WATtR TIE IN(400 FROM INTERSECTIONOF AVERY 9T)
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.
ISSUED BY-- DATE iNSPECTED INSPECTED BY
7/21/2015 9:21 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:; > 6D % -) CONTRACTOR:
LOCATION: l2 ��
TYPE OF WORK: Oa.,,Le r f%e ih - /nu 5L r�7i e�
DATE INSP NEEDED: >�l -IS' DATE INSP:10 540f r
INSPECTED BY: jJ Ff
WORK IN
PROGRESS: r�����- C. C�n1QCYL' , �'-�, �rAr,� _ �n� R-v��-r -ram � .(��►
P/'T CA �iC.K'.aiuC� C%►n»fzz�;T�=�� m a�pL �'n� it iy i �'CAr)5,L
A-v r;,F
SEPTIC TANK PUMPED, SMASHED, FILLED !V/A WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L��� DATE:
S/molloy/forms 2014 Town of South Windsor INPSEC FION 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 $25.00
Name of Firm 2a V)f T �,L�C, Phone No. -zm
Address of Firm ry �� � lip Code
Location of proposed work 1-1
Describe fully nature of permit requested r
Starting date Call Before You Dig Nod__
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut bd Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
-❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
Av P�� - �� No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price$ Ift
L� k Est.Curb Cost$
t I
I Est.Sidewalk Replacement sf
r
-~— - -- Est.Sidewalk Unit Price$ Is#
Wa TOO Est.Sidewalk Cost$
° � Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
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 JOIBSITE AT ALL TIMES Paid By
I AGREE TO FURNI-SH 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 PERMITAND
THAT i AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOITS ST EET CPERMIT MANUAL.
. Signed:-r,� ___.�_ Print Name Date: