HomeMy WebLinkAboutStreet Cut Permits 38 Tudor Hill Road (2) 1600106 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT'PERMIT
DATE: 06/20/2016 'a
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GIS ID:90300038 'r G
MUMS APPLICATION# 201600824 FEE: 25.00
yt w EXPIRATION DATE: 06/20/2017
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APPLICANT J¢ ws. LOCATION
NAME: CENTRAL SEALINQCO II aL r ADDRI✓SS 43$`TUDOR HILL ROAD
ADDRESS: 150 SUNSET RIDGF IWE :E ` i O�VN)rR LTKA ISKAS JOSEPH S&HELEN M
EAST HARTFORD,k 016Ib BSI`JI3.OR HILL ROAD
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PHONE �«t p$ ,eS UT WINDSOR,CT 06074
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WORK DESCRIPTION: DR [VUVAS�'; s G< [ _ f t 4
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APPLICANT AGREES TO FURNISH TH S+TOVI�N OF SOUTHI{T� jI B R 01 OtN' OF ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR;N KP I S 1>rIJIZRED gy TH11 TAD FfSR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND I 'E APFiCNT.TSAMII;�}4R PTT WIT.L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWiV OF SOCJ TH 11ViIVDSq xS BTIF EtiT C TT pE IT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
6/20/2016 12:16 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: 166 CONTRACTOR:_ CCalr4I _�562_12a p
LOCATION: ne 0-
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: -Cl
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: -�
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
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APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT , Permit No.
TOWN HALL 15410 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
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Name of Firm ��Vl r!"YZq-� SSG[ f I 00 1ytC Phone No. S2Q0 !� EI -70d
Address of Firm 1 sl1LYi 5�{" L- V l Zip Code I1
Location of proposed work 171 1` y It 1 I rLZ66L6
Describe fully nature of permit requestedM_(J���' S fTF'42j_e{C�' rt.l� tt.IGLL�4
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Starting date Call Before You Dig No 20 I la J 3-0 /
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PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE EATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed NewjPriveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ ISeptic
Show sketch of proposed work or furnish Indicate North This section to beifilled out by Town
two copies of separate drawing j
No.cuts
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Est.Patch Size(s) i sf
Est.Pvt.Thickness 1 in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$ 1
Est.Curb Replacement ft
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9 N S F Est.Curb Unit Price$ /ft
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Est.Curb Cost$ 1
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Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
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Est.Sidewalk Cost$
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Est.Traffic Hours ; hr
�— --- ------- Est.Traffic Unit Cost$ /hr
Est.Traffic Control
Amt.of Deposit$
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Total Due$
( ( )
Applicant is responsible for contacting the Police Dept and C.B.Y.D }Cash CheclS#
PERMIT$HALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
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I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THP 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 WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S RE�PERMIT MANUAL.
Signed- Print Name �� 1 e erl i Zz(t Date: t�
Street Excav " n Permit 2014