HomeMy WebLinkAboutStreet Cut Permits 14 Rockwell Court (2) 7
PERMITRMIT NUMBER TOWN OF SOUTH WINDSOR, CT
STREET CUT PERMIT
DATE: 05/02/2016
GIS ID:76900014
MUNIS APPLICATION# 201600523 FEE: !�
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105, "*� , ',I.-RATION DATE: 05/02/2017
APPLICANT [
NAME: TELE-NETWORKS # � i i ,is � rfi CCATION
ADDRESS: 31 BAKE WELL COURTi� � L 0� z a� 4OCIELL COURT
CRASTON,RI 02921 �; ,{;' stfi{ram �k rr YIARC P&LAURA E
4r I I LL CT
k � U PHONE 401-461-8420 5 s r } ;� r , w+IIDSOR,CT 06074
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WORK DESCRIPTION: CATV v.x
APPLICANT AGREES TO FURNISH THE T £ ' {'
THE TOWN OF SOUTH WINDSOR FOR ANY k C> ,OUZIWtrr� x n� '` OT`pB $11EQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE� Cp FE TOWN C}
IZCITENANCE OR REPAIR WORK IN
FOR PERMITS AS OUTLINED IN THE TQWN OF ' UTI�WDOjt � IT pI NE BY THE RULES AND REGULATIONS
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ISSUED BY
DAT&S ' ED INSPECTED BY
5/2/2016 1:40 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: ,Co l�Dl 1-7 CO NTRACTC>R: k
LOCATION: G�
TYPE OF WORK: C✓I7��-�
DATE INSP NEEDED: DATE INSP:_ j sir
INSPECTED BY: ���
WORK IN
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PROGRESS: -z--.-�
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor INPSECRON 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 060.74 FEE $25.00
Name of Firm e - 0-e-A 14Q 0 c�-S Phone No. 1' 8U8 1$4-G* 23 C 2
Address of Firm l95 VJ , PAc K $` , ov1ck-e-n c-2 t2-T Zip Code o L9 y 9
Location of proposed work 1'� Kock 7\Rt C-}
Describe fully nature of permit requested V^ C(N l Sk 1 C, C Al r V 1&e
Starting date 7 Z$ 2,61 to 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: Ef"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
see e�,-iiA aCtixe cA No.cuts
0 Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price
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 aft 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.S.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
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 S EET C PERMIT MANUAL. ` -
Signe : � Print Name �� V��� Date: Z 9 I ro
Stree xcavation Permit 2014
On Site 216
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File —rc�illing. services Ustomer.lnformation OrderEntry. .PFV _Firsanci l`.'l�listory • »SD, Help.
Acct Nbr 433613-04
Task �
Marc Richard Co/Dv/Fm
51 lO .426 'Gust Info � .; •
W101 14 Rockwell Ct Phone# Home - 860.644-5696
"View 2 South Vindsor, CT 06074-6901 BUS' Tech#. O
{ �i,�;� 0 Code 0 BURY DROP ,lob Seq
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Priority 5 ..Pool : Job Nbr 000 Tag Nbr 7
Work Order Number; 20687074 Probiem Code
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Work Order Type 3R Special Reczest Addtl Problem'Codes
Ott e History Work Order Status Not coded Primary Finding
Dispatch Comment' Primary Solution,
me Slots.
Work Order Comments PER T71560 1.REPLACE UNDERGROUND DROP.' Pri Loc SU3
mes
Sch Date 5/15/16 7S7f1 STREET SORE/NO TEMP DROP ; Sec Lac
Sch Time ALLDYI xST: AUSTIN CIR Node ID 3TOB63
Ckin Usr Stage
User ID
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