HomeMy WebLinkAboutStreet Cut Permits 89 Heritage Drive (2) 1600191 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/29/2016
GIS ID: 41500089 FEE: 25.00
MUNIS APPLICATION# 201601381 EXPIRATION DATE: 09/29/2017
APPLICANT LOCATION
NAME: QUALITY PAVING CO ADDRESS: 89 HERITAGE DRIVE
ADDRESS: 194 S.MAIN STREET OWNER: GANNON JOHN G&
EAST WINDSOR,CT 06088 - 89 HERITAGE DRIVE
SOUTH WINDSOR,CT 06074
PHONE 860-523-4182
WORK DESCRIPTION: DRIVEWAY
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 ANO WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OU,T,LINED IN THE/TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
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ISSUED BY DATt INSPECTED INSPECTED BY
9/29/2016 12:47 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
--------------- -
TOWN OF SOUTH WINDSOR INSPECTION REPORT
LOCATION: . C'
TYPE OF WORK:
�c'u
DATE INSP NEEDED: DATE INSP: l�
INSPECTED BY:
WORK IN .
PROGRESS:
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor INPSECnON 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 06674
FEE $2U0
Name of F+rt Phone No.. � �► 3 �o
Address of Firm _, -Cod
Location of proposedw.ork
Describe fully nature of permit requested
Starting date Approx:time for completion
Call Before You Dig No. Existing Water Supply: []Public Water ❑Well
Existing Sewage`Service: El Public Sewer ❑ Septic
PLEASE NOTE: THE.DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE,.TEE.AP.PLkPANT�IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH'Af b Ct�IB'REPLACEMENT; NCl fil:I�IN .A1�NCI' MASES INN Ot�ARE a�CURB
LENGTH, -TRAFFIC CONTROL AND THE TONN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch,of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
ot Est.Patch Size(s) sf
Est.Pvt,-Thickness in.
Est Patch Uryit Price$ /sf
Est.Patch Cost$
Est.Curb'Replacement ft
Est.Curb.Unit Price$ /ft"
Est.Curb Cost
Est.Traffic Unit Cost$ /Ftr
:Est.Traffic.Control$
Amt.of Deposit$
Total Due$
- {-)Cash, ( )Check
Applicant is responsible for contacting Paid By
the Police Dept.and.C.B.Y:D:
I AGREETO`: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
CON�}ECTION WITP 1`HIS PERMIT-AND THAt I AM FAMILIAR WITH AND WILL ABIDE BYTt4E-k LES- 6.REGULATIONS.FOR
PERMITS.AS TUNEAlN THE Tt WN_ OF.SOUTH WINDSOR'S.STREET CUT PPPERMIT MANUAL. ;
Signed. Date: 60
Title Driver's License#: _
PLEASE ALLOW AT LEAST TWO 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 10-22608.