HomeMy WebLinkAboutStreet Cut Permits 54 Paper Chase (3) 1600214 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 11/17/2016
GIS ID: 69000054 FEE: 0.00
MUNIS APPLICATION# 201601719 EXPIRATION DATE:
APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS: 54-PAPER CHASE
ADDRESS: 112 PROSPECT HILL ROAD -OWNER: GOLDBBRG NEAL R S&CHERYL E
EAST WINDSOR,CI Dbfl88 - 54 PAPt CHASE
SOUTH WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: EXCAVATED TO IN GAS-SE -V- JCE FROM CURB TO RIGHT REAR OF
HOUSE
APPLICANT AGREES TO FURNISH TMITOWN OF SOUTH VdINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY`"EXPENSES INCURRED BY THE TOWN.FORIVIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT.IS FAMILIAR WITH AI*ID4I1 L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWNbF SOUTH WINDSOR'S TREET CUT PERMIT MANUAL.
G'
ISSUE BY-j DATE INSPECTED INSPECTED BY
1 1/1 7/201 6 2:37PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
---------------- ------ -- -----
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: J CONTRACTOR:
LOCATION:
TYPE OF WORK: f;�rL { z� 10�SZZ I>j LL
DATE INSP NEEDED: DATE INSP:�
INSPECTED BY: ! J
WORK IN
PROGRESS: Ak b-y/
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: f, `' DATE: "( r� .
S/molloy/forms 2014 Town of South Windsor INPSEMOWREPORT 14
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 00074 FEE $25.00
Name of Firm - _ Phone No. ( n c��l :
Address of Firm 1 I i I t Zip Codq.;CLQgk
Location of proposed work 4 _
Describe'fully nature of permit req ested I
Starting deli,. Call Before You Dig No: I ,t fi In 4-to 06
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN�PATCH
�AREA,CURB LENGTH,,TRAFFIC CONTROL AND THE TOWN'S COMRACTp COSTS. THE PERMANENT PATCH lS
1-1 rICAL o VL1VIr LEI fGD YY111-III I A I EAR V1` I/IE TEM—,11 R l l'A T VI I LOVU I I I COULD 0E L;TL.f1 T1+;?�!A'i YtC..n�
Check Applicable: No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
t Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out-by-Town
two copies of separate drawing
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness In.
_ Est.Patch Unit Price$ /sf
., _
I Est..Patch Cost$
�aCh0.�S2� i Est.Curb Replacement ft
?t,(-
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Y
Est.Sidewalk Unit Price
'.` Est.Sidewalk Cost$
Est.Traffic Hours hr
` Est.Traffic Unit Cost$ /hr
... -- - _ Est.Traffic Control$
Amt.of Deposit$
Cr M --
'Total Due$
)Cash OCheck#
Applicant is responsible.forcontacting the Police Dept:and C.B.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
t.,'••'"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 MAINTENANP9 OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
'CHAT I AM FAMILIAk WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S MEET CUT PERMIT MANUAL.
Signed: Print Name��i p2 '1'+3n. Date:
treet Excava. on Permit 2014