HomeMy WebLinkAboutStreet Cut Permits 2273 Ellington Road (2) 1600203 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 10/21/2016
GIS ID: 30302273 FEE: 0.00
MUNIS APPLICATION# 201601554 EXPIRATION DATE:
APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS: 2273 ELLINGTON ROAD
ADDRESS: 112 PROSPECT HILL ROAD OWNER: FIORITA JOHN F
EAST WINDSOR, CT 06088 2273�ELLINGTON ROAD
SOUTH WINDSOR, CT 06074
PHONE
WORK DESCRIPTION: INSTALL GAS SERVICE'
APPLICANT AGREES TO FURNISH THE,TOWN OF SOUTH WIND SORTHE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY gXPENSES INCURRED BY THE TO"FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS 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.
ISSUED BY DATE INSPECTED INSPECTED BY
1 0/21/201 6 9:27AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
- --- ------------
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NQ: t CONTRACTOR: ' �► �`����)
LOCATION: JL,�� -7,'� fs Ili z,, a
TYPE OF WORK: In S M I1. Cl1.C
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: b
WORK IN
PROGRESS:
�EMC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑NO
AS-BUILT: � .
INP�1T: DATE.
S/moHoy/finm 2014 Town of South Windsor DFSEa=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 $25.00
Name of Firm &1e(-: tA(-CQ Phone No. 869 -3 - .2$c�l:.
Address of Firm-11 Zip Code 06,0$
Location of proposed work '
Describe fully nature of permit requested ('
Starting date fib) a (lv Call Before You Dig No 0�0 rr(n'�o`�U
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: 2/No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ 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 two copies of separate drawing Indicate North This section to be filled out by Town
No.cuts
(0 Est. Patch Size(s) sf
?(b W 5 2 L-7 3 Est. Pvt.Thickness in.
11�� �S Est.Patch Unit Price$ /sf
9sa�rlce-
Est. Patch Cost$
Est.Curb Replacement ft
1E t`�G�V1 n8 Est.Curb Unit Price$ /ft
6 `J K Est.Curb Cost$
Est. Sidewalk Replacement sf
I/ +cJb t Est.Sidewalk Unit Price$ 1sf
Est.Sidewalk Cost$
0
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
'� Est.Traffic Control$
Amt.of Deposit$
DRIVEWAYS must be 3ft or more from the property line per Total Due$
section 2.17 of the zoning regulations
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 FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S EET CUT PEF�M iT MANUAL. `
Signed: c C Print Name Date: 'V
___Street-Excavation-Permit 2014