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HomeMy WebLinkAboutStreet Cut Permits 100 Arnold Way (2) 1600123 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 07/13/2016 GIS ID:0450010Q � _ � � 3 FEE: . 0,00 MUNIS APPLICATION# 201600957 r � XPIRATION DATE: APPLICA A x ' LOCATION NAME: EVERSOURCB „ A A OLD WAY ADDRESS: PO BOX 270 '�� SOUT WINDSOR TOWN OF 02 a a HARTFORD,CT 06 �° '� � I1 OLD WAY INDSOR,CT 06074 PHONE 860-292-2242 a 1 V, +{' WORK DESCRIPTION: IN AU. OLD WAY TO SCHOOL PR ? l s` C 4a ARD$&ORCHARD HIL APPLICANT AGREES TO FURNISH T TO =AI „ Ta�T ND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR s , E O TENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND IC�T ,'' `L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TO �_ 1 T MANUAL. ISSUED BY T'AI $1NIED INSPECTED BY 7/13/20163:37PM ** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** 44 llp N N. j � f " s ,., ` v" TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO:: 16 00 A)_ CONTRACTOR: Xv �S v r C, 2 LOCATION: 100 TYPE OF WORK:_ i e.< vrrx►v� - ,rr�vr� 6 r0w 94 .sr��i DATE INSP NEEDED: DATE INSP: /z.lr rf INSPECTED BY: WORK IN PROGRESS: T a, SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO AS-BUILT: INPUT: DATE: S/molloy/farms 2014 Town of Srn.jth Windsor INPSEMON REPORT 14 APPLICATION FOR STREET EXCAVATION PERMIT __ __ Appl.No, TOWN OF SOUTHWINDSOR PUBLIC WORKS DEPARTMENT Iermlt No. TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm '�' �`� 1: (4s, Phone No. Address of Firm 11 444 1 2Q�d l wit..PJ �- C-7" Zip Code ' Location of proposed work &n4ck We i- Describe fully nature of permit requested 9 1,4S A4^0 JZ��J &L7 C;61 Aplck ."►� � o `���I< (�-) e�5`�.!�-��` � `�,Sy o`'�+ uJe.�,'� i� .�"e,�wr2.� �;�I '.� Starting date 2 Call Before Y& Diq No a�ol6 -a7o -3�6S PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE,. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut Rf Pavement Cut ❑ Curb Gut ❑ Sidewalk Cut ❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing No.cuts Est.Patch Size(s) sf Est.Pvt.Thickness in. Est.Patch Unit Price Est.Patch Cost$ Est.Curb Replacement ft Est.Curb Unit Price$ /ft Est.Curb Cost$ Est.Sidewalk Replacement sf Est.Sidewalk Unit Price$ fst Est.Sidewalk Cost$ Est.Traffic Hours hr Est.Traffic Unit Cost$ /hr Est.Traffic Control$ Amt.of Deposit$ Total Due$ 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 RAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSO TREET CUT PE IT MANUAL. Signed: Print Name ' -�!;,�I 06+ _ Date: J9"J �9 Street Excav 'on Permit 2014 Caller Id: 32128 Contact: Mr Collin Nilsen s, �� 1� p3��i '" Address: 112 prospect hill rd Ph: 860-778-2116 Cell: Not Supplied .com Fax: Not Supplied " I � °��-rr ,,; Email• collin.nilsen@eversource :Ticket Type Routine r I I User Reference Not Supplied 'a c >"ate i z i r�z�a s z•'r .t r '��, _ sad1 trs s Ticket Date 07/OS/2016 12:47:07 - ryRdt `> Work Start Date 07/13/2016 Ticket Expiry 08/07/2016 w Xf r,s j $n ` 10D Arnold Way SOUTH wINDSOR m Address wry cW /k� �9�f i rr< z c:a Iva. z rr ar s- L74 t1 n 47,-zY.t' -� Gas - M�rh r {` i Type of work Permit Machine Exc Yt ! a Location of Roadway and Private Property Workplace I _ " ? Location in Road ! Road R.O.W.,Sidewalk,Shoulder 19M. ..I Excavator PERMIT ONLY r fpRlff��'Yf#�t31' �si I l I IS Pre-marked NO r ' Cross-Street Arnold Way Notes/ Description of works s L r F y sL� l'~. ', "" working from prop&going to the intr of gray rd,working curb to curb&street al houses&inst gas service for 380 foster st new road off amold way&at new school THIS IS FOR PERMIT ONLY r , e .Do not proceed with any excavation until all Public Utility owners listed have marked out their facilities or have contacted you directly. s Ensure you adhere to any State legislative requirements regarding safe digging requirements. e If you damage an underground Public Utility you MUST advise the Public Utility owner immediately. For more information on safe excavation practices,visit wmLw c WdsAom The Public Utility owners listed below have been requested to mark out the location of their facilities. Please note they may contact you directly to clarify any aspects of your ticket. # r: CONNECTICUT WATER COMPANY 860-292-2809 1-800-286-5700 NOTIFIED Y/N EVERSOURCE ELECTRIC 800-286-2000 800-598-0628 NOTIFIED Y/N FRONTIER COMMUNICATIONS 1800-598-0628 800-598-0628 NOTIFIED Y/N ON-TARGET LOCATING SVC 1-800-598-0628 800-598-0628 NOTIFIED Y/N TOWN OF SOUTH WINDSOR 860-644-2511 X245 860-644-2551 NOTIFIED Y/N YANKEE GAS SERVICE 860-292-2208 800-989-0900 NOTIFIED Y/N END OF UTILMFS LIST aY fr 3 i . E e` IJill I I 4 Vli O I ti ARNOLD WA Op f yS 4 --------------- 38.0 �- rnlk t. 4 "�"✓'��. 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