HomeMy WebLinkAboutStreet Cut Permits 26 Schweir Road (2) 1600167 TOWN OF SOUTH WINDSOR', CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 08/29/2016
GIS ID: 81300026 FEE: 0.00
MUNIS APPLICATION# 201601180 EXPIRATION DATE:
APPLICANT LOCATION
NAME: CONNECTICUT WATER COMPANY ADDRESS: 26 SCHWEIR ROAD
ADDRESS: 25 NORTH ROAD OWNER: GATOR:,ASSOCIATES LLC
EAST WINDSOR, CT 0608$ - 26 SCHVEIR RD
SOUTH WINDSOR,CT 06074
PHONE 860-623-3355
WORK DESCRIPTION: EMERGENCY WATER SERVICE REPAIR
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY 7 XPENSES INCURRED BY THE TOWIdFOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND VILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
ISSUED B DATE INSPECTED INSPECTED BY
8/29/2016 10:25 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: j CONTRACTOR:
LOCATION A)e &ad
TYPE OF WORK:
DATE INSP NEEdED: DATE INSP: 1�4-
INSPECTED BY: 7
WORK IN .
PROGRESS: j Wit'-- � �;tire `��> "JCA 4"fir r r►
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: rfV�, DATE:
S/molloy/forms 2014 Town of South Windsor INPSEMON 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,CT06074 FEE $25.00
Name of Firm 7— L/,b /- e'--o Phone No. Flo~'Z °) ~Agz C
Address of Firm gZS AL, rid, - Z Zip Code LL(9--
Location of proposed work,, "7 -SC,17 L/{e= IC j
Describe fully nature of permit requested 6me--,A4.--7 c:.e ✓� rc.,es -
Starting date —aZ== —/ Call Before You Dig No �Zc1E 3`fc�r�t 7/ Lre r
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ Rio Pavement,Curb or Sidewalk Gut XPavement Cut X.Curb Out 0 Sidewalk Cut:
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ZPublic Water ❑ Well Sewage Service: Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts..
0 st. Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
L..d- Est.Curb Replacement It
Est.Curb Unit Price
Est.Curb Cost
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Flours ftr
r
Est.Traffic Unit Cost$ Ihr
Est.Traffic Control$-
I
I i Amt.of Deposit$
I �JrtiJ Total Due$
( )Cash O Check#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
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: . . j Print Name 447 �r°��'` Date:
Street Excavation Permit 2014