HomeMy WebLinkAboutStreet Cut Permits 93 Tallwood Drive (3) 1700002 TOWN OF SOUTH WINDSOR, CT
PENT NUMBER STREET CUT PUBLIC UTILITY
DATE: 01/04/2017
GIS ID: 89100093 FEE: 0.00
MUNIS APPLICATION# 201700015 EXPIRATION DATE:
APPLICANT LOCATION
NAME: CONNECTICUT WATER COMPANY ADDRESS: 93 TALLWOOD DRIVE
ADDRESS: 25 NORTH ROAD OWNER- HUTCHINS JOHN F III&
EAST WINDSOR, CT 06088 93 TALLWOOD DRIVE
SOUTH WINDSOR,CT 06074
PHONE 860-623-3355
WORK DESCRIPTION: EMERGENCY EXCAVATION TO REPLACE A WATER--SERVICE THAT IS
LEAKING
APPLICANT AGREES TO FURNISH 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 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. d
- el. 0 1,//a�j I A)117
ISSUED BY DA E INSPECTED INSPECTED BY
1/4/2017 11:50 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
----------------- - -- - -
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: /`7®000 z CONTRACTOR:
LOCATION: !� 3 fii-i 1 w 66d 16 v-t
TYPE OF WORK: -ti) rfwirtc
DATE INSP NEEbED:- DATE INSP: Ll® ,/ 7
INSPECTED BY: 6
WORK IN
PROGRESS: I LL�4-f-t �of
i e^►., Awl c%
SEPTIC TANK PUMPED;SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: (sw�__ DATE: I
S/nid[ W/fomm 2014 Town of South Wmdmr MPSECII N REPORT 14
j
7 �
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 $25.00
Name of Firm (f Phone No. 6
Address of FirM.fb -dc>' mod` Zoi '
Code,OL,(28
Location of proposed work ,3 -. i
Describe fully nature of permit regUest d 0i?2K:=`" c G.+dl, / --: r" c,.: •-
Starting date Call Before You Dig No old S.�l Qom...7 7
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS APRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS, THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cutavement Out ❑ Curb Cut ❑ Sidewalk Cut
❑ 'Existing Driveway,No Changes ❑ 'Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply:: tr-,,'ubiic water ❑ Well Sewage Service: uil Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
SLR Est. Patch Unit Price
Est.Patch Cost
Est.Curb Replacement
' Est.Curb Unit Price$ /ft
Est.Curb Cost
a -
s Est.Sidewalk Replacement sf
/ Est.Sidewalk Unit Price
Est.Sidewalk Cost$.
Est.Traffic Hours hr
v
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due g
( )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 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.
Signed::� ._ ,-� Prlltt warn 1- ✓ -� {
— Date:
Street Excavation Permit 2014
�Jo,� A��
PROP. LINE
CURB LINE
CURB LINE T�LCc� a
PROP. LINE
a