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HomeMy WebLinkAboutStreet Cut Permits 9999 Clark Street (10) 1600218 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 11/22/2016 GIS ID: 20409999 FEE: 0.00 MUNIS APPLICATION# 201601739 EXPIRATION DATE: APPLICANT = LOCATION NAME: EVERSOURCE ADDRESS: :Cl-- ADDRESS: STREET ADDRESS: 112 PROSPECT HILL-AMD OWNER: SOUTH.WINDSOR TOWN OF EAST WINDSOR, C1,6608$ 1544 SULLIVAN AVE SOUTH WINDSOR, CT 06074 PHONE WORK DESCRIPTION: INSTAISL`GAS MAIN TO-NEW 80A]XVISIO CLARKISTATES CLARK-ST @ MARGARET DRIVE APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE'AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANNtXPENSES INCURRERBY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE APPLICANT,IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN`OF SOUTH WINDSOR'S STREET CUT-PERMIT MANUAL. / / ISSUED BY DATE INSPECTED INSPECTED BY 11/22/2016 9:47 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: ) CONTRACT©R: LOCATION: TYPE OF WORK: ;'o-SIA 1 �l to lax,(T\ � � A DATE INSP NEEDED: DATE INSP: —4L.74Z INSPECTED m T L WORK IN / PROGRESS: SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO AS-BUILT: INPUT:_ DATE: S/molloy/forms 2014 Town of Smith Windsor INPSEMOWREPORT 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 $25.00 Name of Firm Cks Phone No. Address of Firm �" G j Zip Code Location of proposed Work + . Describe fully nature of permirroquetwo jnsiatt Q&b rna-ir� Starting Call Before You Dig Nt Ito q6,0 45 PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut M-Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut ❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic Show sketch of proposed work or furnish Indicate North This seellon to be IfIled-out by Town two copies of separate drawing No.cuts Est.'Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price$ dsf 1 Est.Patch Cost$ I Est.Curb Replacement ft I eco r�dI n Est.Curb Unit Price$ (ft f Est.Curb Cost Daft G� rn'Q} ° Est.Sidewalk Replacement sf i " Est.Sidewalk Unit Price Est.Sidewalk Cost Est.Traffic Hours hr .� Ca 15 Est,Traffic Unit Cost$ /hr Est.Traffic Control$ � l Amt.of Deposit$ DRIVEWAYS must be 3ft 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.YD 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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH 1 tit 060; i ET CUT PtRM[I` Ati>fUP L. Signed* a, .A Print NamBa � Date ? Street av8tiiur Permit 2014