HomeMy WebLinkAboutStreet Cut Permits 15 Allen Drive (2) 1600124 TOWN OF SOUTH WINDSOR, CT
PENT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/13/2016
GIS ID: 02100015
MUNIS APPLICATION# 201600958 FEE: 0.00
EXPIRATION DATE:
APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS: 15-ALLEN DRIVE
ADDRESS: PO BOX 270 OWNER: BENTLEY MICHAEL F
HARTFORD, CT 06141 15 ALLEN DRIVE
-SOUTH-- INDSOR, CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: EXCAVATE TO INSERT GAS SERVICE TO RELOCATE FOR NEW ADDITION
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OE BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FORMAINTENANCE 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 WINDSO�Q 'S STREET CUT PERMIT MANUAL.
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ISSUED BY
A E INSPECTED INSPECTED BY
7/13/2016 3:40 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
-----------------
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1600/a CONTRACTOR: E ye(s®y Kif e
LOCATION:
TYPE OF WORK: iYI r-�- �, _ 1y`i1 tL,�Q D�r�+ r ; r I/l OddlO01"'
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:_&D
WORK IN
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PROGRESS: /� .� �1 "�� /►' < .
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: Cr �, DATE: Ile
S/molloy/forms 2014 Town of South Windsor INPSECIION 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 $25.00
Name of Firm [N E IZ-61 7 Lk I-C ,E Phone No. 162 — 2 54.— Z S
Address of Firm e CCT H ) it A D 9 F, 0 t An � 0 f", Zip Code p6 D 89
Location of proposed work L C,A)
Describe fully nature of permit requested C2(C,,ay'n-V F V�7 ) go � �'�°'�_�
�T,D 6 GILD d Ay- )p yp K AV 1 ' b-I'9 �-"i D n1
Starting date_ `7 -- �, Call Before You Dig NoZ Q/ 6 ?- 7 b
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: 0 No Pavement,Curb or Sidewalk Cut * Pavement Cut ❑ Curb Cut CJ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est.Patch Size(s) sf
Est. Pvt.Thickness in.
t Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement It
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Iva 7
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
,) Est.Sidewalk Cost$
A C'
Est.Traffic Hours hr
i 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 STREET CUT PERMIT MANUAL.
Signed: _ La�� Print Name rd ,i ie Date:
Street Excavation Permit 2014
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