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HomeMy WebLinkAboutStreet Cut Permits 44 Oak Street (4) 1600224 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 12/2I/2016 GIS ID:65400044 ;�'f FEE: 0.00 MUNIS APPLICATION# 201601862a� S rXPIRATION DATE: a ci''3iStn PT t APPLICANT',y h` ..0 LOCATION y a Y w NAME: CONNECTICUT WAFER COMPANY ADDRESS 4A STREET ADDRESS: 25 NORTH ROAR Si F ~`� i ., ,b VNER KRYSI' SKI JOSEPH EAST WINDSOR, ox oz 8d C AI STREET y M y F SbTiTI INDSOR,CT 06074 PHONE 860-623-3355 s l ',v4` r 4 rtir.r 3�y v F.• s,�c5r WORK DESCRIPTION: REATi ECT)1N � AERINRATC INASS AREA ON WEST E� SID APPLICANT AGREES TO FURNISH' � OFE © IaND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINbSOR FOR. I�'�pENSES II CCI1 D ET'zTHE V kf R,%TAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND TIDE APBR Gt>NTIh�ArlsR WHAi±jD2V1I L ABIDE.BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN W S(;►OTIM445,SC3 ',S STREET TPETtMIT MANUAL. L }fld ISSUED BY D TE INSPEC ED INSPECTED BY 12/21/2016 11:15 AM *** PERMIT TO BE KEPT ON .JOB SITE AT ALL TIMES*** --------------- ------------- &;q gls t L, �� l3 .'`�,a 1 ?a�r'� x`SPy t•"' �� flFr ` (g. sWWI i_ C��r TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: C ..LOCATION:-9 Oar, TYPE OF WORK: xf- J . DATE INSP NEEDED: DATE INSP: /Z1..2.71/G INSPECTED BY: -Zt.� WORK IN PROGRESS: G / lz,-'�� ; --� /"�,r'¢z,`✓� �j'; ,r �r AAAA, "n UAL Sri A - zrk44 SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: \ DATE:­�,j \ S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION 4 I e APPLICATION FOR STREET EXCAVATION PERMIT ......:......:. Appl. No,.: TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. E TOWN HALL 1540.SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00 Name of lFlrttl .a°: t" .96b - _ mac;: Phone No......- p279P2-'r?2 Q I Address of ='% Code Location of proposed wrk . +Describe fully nature of permit requeetf3d k - . .� .s'•c grit•,. ....:" ........... f Starting tt ./� +.�.- f :Call Before You Dig PLEASE NOTE; THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH-AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN-St.CONTRAGT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD'BE LATER THAN A YEAR. Check Applicable: ' No:Pavement,Curb or Sidewalk Cut I] Pavement Cut ❑ Curb Cut ❑ Sidewalk'Cut ❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Vuater`5f� ply Pptaffe AT.er .1 W�sn :Sewn e•Sery ttkll Sprver•. C7 S tc. t: Show sketch of proposed work or furnish indicate North. This seetbn to be ffllgd.QW by Town two copies of separate.drawing No.cuts ..:.... I A/77A Est.Patch Sizes) sf a. . ;I Est.Pvt.Thickness In. Est. Patch Unit Pncei Est.Patch Cost$ I I Est.Curb Replacement. : ...........:........:.:.:.::.. : . Est.Curb Unit Price Est.Curb Cost$ ... Est.Sidewalk Replacement sf Est.Sidewalk Unit Price$ /sf Est.Sidewalk Cost'.::...... ... .. ....: : Est.Traffic Hours;...._...... _............ ....._ ' �r - i Est.Traffic Unit Cost$ /hr �✓ Est.Traffic Control 1 Amt..of Deposit$ r l .Total Duel, , t ` Cash O 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:..:............... ' ... ......... ! ... :........ .... ....: 4 I AGREE TO FURNISH.TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH E 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 ASOUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: '-�' . . ' '"-.�.`'1 Print Name./ Street Excavation Permit 2014' ._ ._._ .tz . Wt .... - r. a : ri<' i 4e¢ w tY