HomeMy WebLinkAboutStreet Cut Permits 48 Jonathan Lane (2) 1600139 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/18/2016
GIS ID:47800048 FEE: 25.00
MUNIS APPLICATION# 201600984 .EXPIRATION DATE: 07118/20I7
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APPLICANT- q,. 'rz �` >Y "k LOCATION
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NAME: AYOTTE BROTHER%CONST CQ lNC AI7DRSS k :rOATHAN LANE
ADDRESS: P O BOX 498 O�WNE fAGNt NANCY A
SUFFIELD,CT 06078 s <' �$ fNATHAN LA
L SQUTT,.H iNINDSOR,CT 06074
PHONE 860-654-1800 tiK
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WORK DESCRIPTION: DRI�VAY
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APPLICANT AGREES TO FURNISH THTOWN QR071TH WI �7SQRrHE=AM ?ilT,�Ii SrND REQUIRED AND TO REIMBURSE
TI IE TOWN OF SOUTH WINDSOR FO Y X R A PEI*iSES 1Ji RFs)?MU
HE TOWN F MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APP ICtJN3,IS FATvII ew TH IDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S(UTIH VFIDSORrS$TI' ET CT� PI RMIT MANUAL.
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ISSUED BY DATE>I1PEC'I`ED INSPECTED BY
7/18/2016 11:55 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: �� CONTRACTOR: �Lo �/ r'.S
LOCATION: _ d r.� Gt n
TYPE OF WORK: V-e c'Ja,
DATE INSP NEEDED: DATE INSP.,
INSPECTED BY: 6
WORK IN
PROGRESS:
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: DATE:____ .'_. /„�
S/molloy/forms 2014 Town of South Windsor INPSECMN 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 06074 FEE $25.00
Name of Firm q b 1-6 Is llJr1 T/IC - Phone No. & 6,54 .1 az?
Address of Firm a Zip Code 0(e0'7R
Location of proposed work �)2 th qA LCI.f'1G
Describe fully nature of permit requested ACM6✓ 2 iff d x i01 C i'S fill)q drIVe UjJ rePf �z
Starting date e1116-1/lo Call Before You Dig No Z61& 01842'
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish 34 Indicate North This section to be filled out by Town
two copies of separate drawing
0 No. cuts
Est. Patch Size(s) sf
Est. Pvt. Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ /ft
Est. Curb Cost$
Est. Sidewalk Replacement sf
-rovq N W 1t14- Est. Sidewalk Unit Price$ /sf
Est.Sidewaik 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.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 EXPENSE
R INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT I A IL WITH N WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINEDIN THE TOWN OF SOUTH
WINDSO S S EET I T P IT MANUAL,
Signed: Print Name CWQr ' d�f� Date:
Street Excavation Permit 2014