HomeMy WebLinkAboutStreet Cut Permits 66 Greenwood Drive (2) 1600076 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/25/2016
GIS ID: 38700066 FEE: 25.00
MUNIS APPLICATION# 201600669 r EXPIRATION DATE: 05/25/2017
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APPLICANT , f y k LOCATION
NAME: TELE-NETWORKS qF 4 ADDRESS ' i66 GREENWOOD DRIVE
ADDRESS: 31 BAKEWELL COilRTY� 1 OWNED � IECHQWSKI ROBERTA K
CRASTON,RI 0292 r' ` }b6 WOOD DR
Y< ' vg5 ?UTPT WINDSOR CT 06074
PHONE 401-461-8420 r;
WORK DESCRIPTION: INS ALL RI'�ACE CATV z` t a 3
APPLICANT AGREES TO FURNISH TH ,TOWi`'OF` O`[JTFI=1�UINDO `FHE"AMO�INTSO BAND REQUIREb AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR 1 PEI S 1N IIRREII$Y T B TOW Tk O1 MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TFIE AzPPLTCANTIS PAI1%III IAR VCrITH 1D WILL ABIDE BY THE RULES AND REGULATIONS
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FOR PERMITS AS OUTLINED IN THE TOWN NF 46tTI IINDSOR'S STl> EEYriT IT MANUAL.
ISSUED Y DATE WSPECTED INSPECTED BY
5/25/2016 2:49 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: 7 CONTRACTOR:
LOCATION: �o ? �1 (A 0 a j
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: fT l ram,
INSPECTED BY: �
WORK IN
PROGRESS: .0 -
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloy/forms 2614 Town of South Windsor TNPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
hTOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00
Name of Firm lv S Phone No.
Address of Firm �� C (� S C()vt VICE � Zip Code On
Location of proposed work (.st Ceen Or .
Describe fully nature of permit requested r C?W
Starting date Call Before You Dig No q0 S 01
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WI IN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est.Patch Cost$
Est. Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est. Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
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
{ )Cash ( )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 TREET C PERMIT MANUAL.
Signed: Print Name Date: 1(-e
Stre Excavation ermit 2014
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Filec its B�Uing Servi=e; CustamerInforrriation ;7rder Entry RR F�nanc�al Histoiy. :HSD _welp
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Acct Nbr 491091-01 TaskExit = `
Roberta Ciechowski CofDv/Frn 51 10 426 Cust Info
Prt W/o 66 Greenwood Dr Phone# Home 860 644-3400
'View 2 South Windsor, CT 05074-2957 Bus 860 528-5967 Tech# 0
Exit and Retain 0 Code 0 BURY DROP Job Seq
Priority 5 Pool J Job Nbr 000 Tag Nbr 456379
Pts Work Order Number 20715800 Problem Code
Svcs Work Order Type SR Special Request Addtf Problem Codes
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Work Order Status Not Cede¢ Primary Finding .
Time Slots
Dispatch Comment ^ Primary Solution .
'Work Order Comments 125FT UNDERGROUND DRIVEWAY BORE Pri Loc SW4
Prorates
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Sch Date 5/15/15 AND_A SNALL_WALKWAY BORE _i Sec Loc
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Sch Time ALLDYI
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Comments
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