HomeMy WebLinkAboutStreet Cut Permits 200 Debbie Drive (2) 1600140 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 07/18/2016
GIS ID:26700200
MUNIS APPLICATION# 201600985 FEE: 25.00
EXPIRATION DATE: 07/18/2017
APPLICANT " LOCATION
NAME: BOUTIN&SONS ADDRESS: 200-DIBBIE DRIVE
ADDRESS: 121 WINDSORVILLE ROAD OWNER: SZE JOSEPH CHI KONG&
BROAD BROOK, CT 06016 206 =IDEBBIE DRIVE
PHONE 860-623-2526 SOUTH WINDSOR, CT 06074
WORK DESCRIPTION: DRIVEWAY
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF B OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR-
OR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND WII L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN-OF SOUTH WINDSOR'S STRE T CUT PERMIT MANUAL.
�(1�\ Z
ISSUED BY D TE IN PECTED
SPECTED BY
7/1 8/2016 1 1:58AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: CONTRACTOR:
LOCATION:
q
TYPE OF WORK: J
DATE INSP NEEDED: DATE INSP: t Z $
INSPECTED BY: o
-
WORK IN
PROGRESS:
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: C DATE: -1 j
I
S/molioy/forms 2014 Town of South Windsor INPSECRON 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 $25.00
Name of FiWUTIN AND SONS CONST Phone No. 860 623 2526
Address of Firm 121 WINDSORVILLE ROAD BROAD BROOK CT Zip Code 0601 6
Location of proposed work 200 DEBBIE DRIVE
Describe fully nature of permit requested RFMnVF AND RFPT A("F F-XTgmTN 3 r)RIVEWAY RR.QM
STREET TO GARAGE
Starting date 7/1 6/16 Call Before You Dig No 2 16 2 8 0 3 0 6 6
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
-fR Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out bV Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est. Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
i
Est.Sidewalk Cost$
Est.Traffic Hours hr
i
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
DRIVEWAYS must be aft or more from the property line per 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 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 STREET CUT PE ITT MANUAL. /fr' n 6J 7/1 3/1 6
Signed: �-�-�����, C'"- �--� Print Name
Street Excavation Permit 2014