HomeMy WebLinkAboutStreet Cut Permits 72 Heritage Drive (2) 1600189 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/29/2016
GIS ID:41500072 FEE: 25.00
MUNIS APPLICATION# 201601379 EXPIRATION DATE: 09/29/2017
APPLICANT LOCATION
NAME: QUALITY PAVING CO ADDRESS: 72 HERITAGE DRIVE
ADDRESS: 194 S.MAIN STREET OWNER.- 1 UCCIGROSS MELISSA J
EAST WINDSOR,CT 06fl88 72 HERITAGE DRIVE
SOUTHWINDSOR, CT 06074
PHONE 860-523-4182
WORK DESCRIPTION: DRIVEWAY REPLACEMENT
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 WII L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S TREET CUTPERM- IT MANUAL.
4�14 /
ISSUED BY DATE INSPECTED INSPECTED BY
9/29/2016 12:40 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
n '
------PERI—T—
MFVO:: — — — ----- CONTRAET'OR:— — —
LOCATION:
TYPE OF WORK: &A3C.(
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: r c..yIL
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT:
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT �_
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR, CT 06074
FED
Name of Flrm' , T Phone taco: v1
Address of Firtn 1 r "
o
Zip Cde
Looatiorrof°proposed work
Describe fully nature of permit requested47
Starting date Approx.time for completionC2 jai
Call Before You Dig No. `77"7 D YT t' Existing Water Supply: : ❑:Public Water ❑Well
Existing Sewage Service: []Public Sewer ❑ Septic
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 CURS 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.
Show sketch of proposed work or furnish This section to he filled out bv,
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
Aw t
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft .
Est.Curb Unit Price$ Jft
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Est.Traffic Control
r U Amt.of Deposit$
Total Due$
)Cash. ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.D::
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 TLIN' IN T E TOWN OF SOUTH WIN'DSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:- 7 ^ l
Title: Driver's License m o�553 q�lG'7
PLEASE ALLOW AT LEAST TW WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street:Excavation Permit 08 REV`10-22-08