Loading...
HomeMy WebLinkAboutStreet Cut Permits 14 Windsorville Road (2) 1600223 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 12/21/20I 6 GIS-ID:95700014 zy FEE: 0,00 MUNIS APPLICATION# 201601861 EXPIRATION DATE: APPLICANT al LOCATION NAME: CONNECTICUT WATER CQMP4IY DSORVILLE ROAD ADDRESS: 25 NORTH ROAD J4 OWNRrI� SAWE§MARIE L EAST WINDSOR,&6608 f]}4 Il DSORVILLE RD Y4, a' ,SIOUTIWINDSOR,CT 06074 PHONE 860-623-3355 f r ` *h or WORK DESCRIPTION: EMEIIGIEIV !�U�7�,TE V CI;CCI IEC ---w I'@R f)RY WELL C01NFTT�OISIIADF� F RX, TREµ ; .! APPLICANT AGREES TO FURNISH THT01 DFO�7PHf11UfI�3 [�I3E Al�i�1[IVY OFt7ND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR 'LIYSES CCJRItETj BY 3ME Y WI FAR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT ANDF "'4I ItJANT IS IL�IARH Ala1D�(�I L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUT;To/ IN THE TOWNF SQITH 1TND�' STRt�$T CUT ETxZMIT MANUAL. Cl S ISSUED B INSI�E`C`TED INSPECTED BY 12/21/201611:02AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ------------ fa a p sf t g s " 4'�.�' Fez L5•rF F �2k .� `dam>it�+ ,my � ' 1.pig�z 1 f :fi'} �y .� 4 1 t $ + 5 rv�4'Ai sy �w per. =8 slmA oT�. N, ji ` 1 m �T � ��x k ti 1� S � .c�s'✓ R ° Y TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 1J CONTRACTOR: LOCATION: wti l q dso('v f )le ioad TYPE OF WORK: tL),qs�t DATE INSP NEEDED: DATE INSP: Z INSPECTED BY: WORK IN PROGRESS: 1 [.�w;�-e ✓vt. Q G� 7 S t MCI SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION i 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 $25.00 — ' .. ��z ago � Name of Fifib'= 0 :f-C/ Phone No.- a Addressof,f.I �'O x �S 7 -. ��,�, h so C f Location of proposed world /.: ^ .�:�� ; =.t - �: = Describe fully nature'of perm it,rtllrsf0d �:nre= `' � �'' S ..........f n .:crb.�. � ............ ...:.. .............. ........ . _ .. Starting date � J' Gill.Before You Dig No PLEASE NOTE. THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE: THE APPLICANT 18,RESPONSIBLE FOFf THE FULL FINAL COST OF THE PERMANENT PATCH ANDCUR&REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT.COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: D No Pavement,Curb or Sidewalk Out Payement Cut ❑ Curb Cut 0 Sidewalk Cut ❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Wlt®a Supplyc Puf�ill W V�l.11 Sewage S�cutae ;.tibtic EeHrex © 5eplfr : s• Show sketch of proposed work or furnish indicate..North This section to be filled out by Town two copies of separate drawing No.cuts Est. Patch Size(s) 8f `m Est. Pvt:Thickness . __ .in. Est.Patch Unit Price* I`St Est.Patch Cost$. Est.Curb Replacement:. ft Est.Curb Unit Price:$ /ft Est.Curb Cost;$ Est.Sidewalk Replacement sf Est.Sidewalk Unit Price$ /sf Est.Sidewalk Cost i Est.Traffic Hours ...........................................-........._......-hr Est.Traffic Unit Cost$ /tiC ........._...... .... Est.Traffic Control;. Amt.of Deposit$ Total Due; ; { ( )Cash ( )Check#_ ,w Applicant is responsible for contacting the Police Dept.and C.B.Y.D PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By... u 1.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 WI.LI,gBIDE-BY THE RULES AND REGULATIONS FOR PERMITS AS'OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.. Signed PrintName' i�cC C; -'2 pate, it a Street Excavation Permit 2014 Y L cr _l A .. .. n .ti .. .n e �y •,fir.. A i } W� 5. ' key w ,n * , - #'� - irPjZOi�1'u:;..t,C�a 7titt t4l r�{r iziS a t_C E1�fS a� S Ur ... ;:. .. ..y, .':i " '��k'y. ::.ctk•.+:C 3k�� • :3a^,�3'L'iv.,A e�a:s^l.',ii�. . .. „ ... ... .: ..> •a al N h. Y .. t A. ... .. .. .: ::. �s ' •aC