HomeMy WebLinkAboutStreet Cut Permits 357 Nevers Road (2) 1600115 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/28/2016
GIS ID:62400357 FEE: 25.00
MUNIS APPLICATION# 201600885 EXPIRATION DATE: 06/28/2017
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APPLICANYT F LOCATION
NAME: HOMEOWNER l ADDRESS 35 NaEVERS ROAD
ADDRESS: 357 NEVERS ROAD "t OWN+It, VU TU 1G-T&HUUYNH MY-T
SOUTH WINDSOR,ICT�16074� 357 T R ERS ROAD
1i0UTHlWINDSOR,CT06074
PHONE IQ
WORK DESCRIPTION: DR=V FVA��,-,A. NT WIL'J 1I TT E EhTI 'Ak ifiE;}APRON IN THE ROAD
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APPLICANT AGREES TO FURNISH TH TO NlOF OTYTH3I L�S()R,WjE AMbI % 1T Q ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A1I3XPEIISES I1�CR13ED'$Y THE TO, J1*I FOR>1VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND' A�'1�L�CA iT IS FAMI> IA-R KITH AI iI�V�ILL ASIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWNOF SGi3THIt>IDSI'}�'_S STREET C[rTJrItMIT MANUAL.
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ISSUED BY DATE<INSPECTED INSPECTED BY
6/28/2016 9:15 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: 16 00I<-6- CONTRACTOR: n7e o to (ke(Z
LOCATION: eu)ers Knac)
TYPE OF WORK: LK 1 V6°00-�4 A0 2& - - --
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:.
WORK IN
PROGRESS:_„_ - -
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: �'_ ►N\, DATE:
S/molloy/forms 2014 Town of South Windsor INPSECTION 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 $25.00
Name of Firm - L)tJ6'r' 1 1 U Phone No. �?&0- 707— 9-7S t;
Address of Firm G Zip Code n6n7cs
Location of proposed work rl '
Describe fully nature of permit requested
Starting date Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out-by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ !sf
Est. Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ 1hr
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 EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT I AM F ILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S S EET T PE MIT MANUAL.
Signe ' Print Name -I It _ Date:
Street Excavation Permit 2014