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HomeMy WebLinkAboutStreet Cut Permits 36 Graham Road (2) 1700001 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 01/03/2017 GIS ID:37500036 FEE: 25.00 MUNIS APPLICATION# 201700008 "' '% EXPIRATION DATE: 01/03/2018 Zk �t 4 �J APPLICANT rY3y LOCATION NAME: SKIPS WASTEWATBIt s AbDRESS 36.6RAHAM ROAD ADDRESS: 21 COURTNEY DRI Y1;..•,J OWNERi f ALARECHE ROLA ELLINGTON, CT Ofxt32� =} 6 tM HAM ROAD µFA Y ©UTH WINDSOR, CT 06074 PHONE 860-875-2332 ii r t M 9 WORK DESCRIPTION: TRENQH IATQ ROA7� TQ CON `TTO S'�4NI��,RI EWER MAIN FOR 36 GRAIAM R } ORNR OF AYEItS 3 �x05 APPLICANT AGREES TO FURNISH THE OVEN Q SOUTHDSQR AMQIJITSOI BfJND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY" €PE ISES II QCJRRED$ -'RE'TQrW]g:Z R,IvIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND T IE API',LIC`ANT I FA1viII fAR WITH ANgovL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN Cal'�15 VCIINDSQ ' .STREE3 fiUT I'ERIVIIT MANUAL. ISSUED BY D ]1TPECTED 1NSPEC D BY 1/3/2017 4:03 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** . x U� s Lam} A q1� Yti 1 :.0 1 ,ro5tc 4� �23rr' All } l 4 F t TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: j :Z 0 0 a a/ CONTRACTOR: 1c; i 3 DATE INSP NEEDED: DATE INSP: 1 INSPECTED BY: WORK IN PROGRESS: f SEPTIC TANK PUMPED,,SMASHED,FILLED WITNESSED ❑YES ❑NO AS BUILT: INPUT: C' DATE: w J r J S/moRoy/fom s;914 Town of South Windsor I011156 ilOW EDORT 14 APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm � r P.!V 4V -+5 T z-TL Phone No. 0 7:5'^Z 33 Address of Firm 2 Cd-7-11C7i nJ C y ,Z)7z- 1-- 6'7-3 _ _ _ Zip Code e 4 0 Z 9 Location of proposed work 3(- G 1Z I9 f/fj I" CO? 2 ' Describe fully nature of permit requested UC X4 'a _ lr�� �j tp CAN jv e c`7 s9 c—f t_x- !Lr 4..J Starting date Call Before You Dig No PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut ❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic Show sketch of proposed work or furnish Indicate North This section to be filled out-by Town 1'w two copies of separate drawing No.cuts f A sf Est. Patch Size(s) Est. Pvt.Thickness in. Est. Patch Unit Price$ /sf Est. Patch Cost$ Est. Curb Replacement ft Est.Curb Unit Price$ 2 7 /ft ca Est.Curb Cost$ f 4�p ,may Est.Sidewalk Replacement -- sf Est.Sidewalk Unit Price$ � /sf Est.Sidewalk Cost$ Est.Traffic Hours hr _ Est.Traffic Unit Cost$ /hr r Est.Traffic Control$ r Amt.of Deposit$ _'DRIVEWAYS must be 3ft or more from the property line per Total Due$ ,G� section 2.17 of the zoning regulations ( )Cash (►Check# 17 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�iyvG � AGE dfUz s 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 EXPE ES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THAT I AM,FAMILIAR.V1d!T T.Ir�WILL AI?'71F _RULE" AND REGULATIONS FOR PERMITS AS OUTS.IN" IN THE TQ!nrr.--,F ' IITH _ WINDSOR'S STJRPET C 147 4 MANUAL. Signed: Print Name �l � ' �'�' �`2` Date: j� �� TOWN OF SOUTH WINDSOR ENGINEERING DEPARTMENT ADDRESS PERMIT NUMBER INSPECTOR TEMP. PATCH DATE INSPECTOR COMPLETION PATCH DATE .o or a I i