HomeMy WebLinkAboutStreet Cut Permits 117 Cliffwood Drive (2) 1600055 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/04/2016
GIS ID:21000117
MUNIS APPLICATION# 201600543 FEE: 0.00
EXPIRATION DATE: 05/04/2017
APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS: 11`7 CLJFFWOOD DRIVE
ADDRESS: PO BOX 270 OWNER: BURNHAM GARY R JR&RACHEL A
HARTFORD,CT 06141 ll T CLIFFWOOD DRIVE
SOUTH WINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: IN9-TALL'GAS SERVICE
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDW SHE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY PEN3ES INCURRED BY THE TOWN 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.
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ISSUED BY
DATE SPECTED -
SPECTED BY
5/4/20 1 6 2:41PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: & O CONTRACTOR:._ 4:�7\/e C �✓C
LOCATION: II7-r=�i f �jo
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TYPE OF WORK: Ste\/
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS 5' C
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: E,�1�� DATE:
S/molloy/forms 2014 Town of South Windsor INPSECTION 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 \(e Uk-rC-P, Phone No. v-315`2Z 6 2-
Address of Firm C"F c . &34 S �SU t' Zip Code C Cc�C�i'�d
Location of proposed work 11 ' i p ;
Describe fully nature of permit requested_ Tashi 11, qa_ s r y;ck-
Starting date Call Before You Dig No
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 2rPavement 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 fumish Indicate North This section to be filled out by Town
two copies of separate dre wing
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
111 Est.Patch Unit Price$_/sf
Est.Patch Cost$
Est.Curb Replacement ft
ti" CLPfY1 Est.Curb Unit Price$ /ft
KO Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
CLIFFWboD I I A2
Est.Traffic Hours hr
rtnII
Est.Traffic Unit Cost$ /hr
i Z"PLGA51114 la — — __
3�Y 31 Est.Traffic Control$
n Src-S S Amt.of Deposit$
Total Due$
(Applicant is responsible for contacting the Police Dept.and C.B.Y.D )Cash OCheck#
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
WINDSO TREET,CUT PE MIT MANUAL.
Signed: Print Name Ipu(I e- l t Date: 201
Street Excavation Permit 2014
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