HomeMy WebLinkAboutStreet Cut Permits 9999 Pleasant Valley (10) 1200029 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 03/26/12
GIS ID: 72909999 FEE: 00
MUNIS APPLICATION# 201200310 - EXPIRATION DATE: 03/26/13
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APPLICANT. LOCATION
NAME: GLENN DRILLING - ADDRES&s PLI OiNT VALLEY ROAD&LONG HILL
ADDRESS: 532 NEW LONDON ROAD 6ftER -----,-TOWN 4 SOUTH WINDSOR
COLCHESTER, CT 064f -1827 IS40��41VAN AVE
w( VT--,WINDSOR, CT 06074
PHONE 860-537-3601
WORK DESCRIPTION: TESTPR--QN WATER 1VfAI�I TC}WNI? O7ET N9 FEE "
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH tDSfR �HE=AMOUIT OEBOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY=EPENE3INURRI BY=1`HE TpWN F{�R 1VIgINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS 1 AM1LIAf WITI�ANII,WIL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOU IUVINT3SR'S TREE T CUTPERM"IT MANUAL.
ISSUED BY DAI`ENShECTED PECTED BY
3/26/20123:34PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: Glenn 7 lli n�
LOCATION:_ I P�5 .,�-�' \� I I�u cr 006
.TYPE OF WORK:___ S {, -
DATE INSP NEEDED: -3c�—J2.., DATE INSP:
INSPECTED BY: JJ(�
WORK IN
PROGRESS: tfJk can„ cam; ,
SEPTIC TANK PUMPED, SMASHED, FILLED UIa WITNESSED ❑ YES ❑ NO
'AS—BUILT: Nr"\
INPUT:- DATE: cJ
W12007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appl• No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC.WORKS DEPARTMENT i
1540 SULLIVAN AVENUE Date: �l L a
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm 1 f/✓ 6 r-
Phone No. 5�6
Address of Firm 5- -A✓e l f L-01, - , t�cix h =5 Zip Code ae5
Location of proposed work n . V 1 _ ral L r e �r-
Describe fully nature of permit requester!
Starting date 1 8 j f 7 Approx.time for completion o —c;�
Call Before You Dig No.a o( 1 a' l — Existing Water Supply: 0 Put&Water ❑well
Existing Sewage Sery oe: ❑Public Sewer Q Septic
PLEASE NOTE; THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC-CONTROL AND THE TOWN-S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Show sketch of proposed work or furnish
two copies of separate drawing T_ #pis se6fim to be fixed out by
Indicate-North Town of South Windsor
No.pats
Est Patch Size(s) sf
EsL PvL Thickness
Est Patch Unit Price$ dsf
Est.Patch-Cost$
Est.Curb Replacement ft
EsL Garb Unit Price-$_ tft
Est:Curb Cost$
EsL Traffic Unit Cost$ thr
Est.Trafft Control$
Amt.of Deposit$
Total Due$
( )Cash { Check#
Applicant is responsble 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 PERMT 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 PERMIT MANUAL
Signed: Data: l l Q I ems_
Title: L q c,rT Pam,^ Driver's License#: 03� 2 / c:)11
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 TUNES
Street Ekovatim Penrdt 08 REV 10-22-08