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HomeMy WebLinkAboutStreet Cut Permits 585 Griffin Road (3) 1700046 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 03/22/2017 GIS ID: 39000585 FEE: 0.00 MUNIS APPLICATION# 201700260 .4 N TXPIRATION DATE: is C` �4 4 .k t � L w is. APPLICANT ' kY„ . LOCATION NAME: CONNECTICUT WAR C4MPEINY ASDRSS �585`GIIFFIN ROAD ADDRESS: 25 NORTH ROAD f" ;r �4 " OWNIZ IILLIG AURETTE EAST WINDSOR,CT 0�b88 t s 7 T 55�k% RTFFIN ROAD bUTH OVINDSOR CT 06074 PHONE 860-623-3355 y `v x,i zt WORK DESCRIPTION: INStT�I IT�TW 1� C TS7OV 'VILST� 2; �TQ MOLE ACROSS ST APPLICANT AGREES TO FURNISH THEE t O �f1F SOiITH II D t3�$�IE tuvi, UI FT pF B ND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR X%,"MPANSES DIGU 13 T i T s f�S�tMAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND T APF ICA�1T IS PAMII MAR W Hr.�,Ai�1•D W.tDL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN bT Sdb WIND OR 3 STRE ULJT EI 1vIIT MANUAL. ISSUED BY D 'TE INPECTED INSPECTED BY 3/2212017 4:00 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** t gn, k f TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMTI'NO:. �� , CONTRAMR: LOCATIaN; Lc�m TYPE OF WORK: a `�'� DATE IMP NEEDED: DATE INSP: ' /T INSPECTED By..--!- WORK 14 PROGRESS' '' ` .J ; :� SEPTIC TANK.PUMPED;SMASHgD,FILLED WITNESSED ❑YES Cl NO AS-BUILT: INPUT: DATE: g-y^1-7 s/moifoylvoms=4 Tm of south Windsor i(ops Mi+J•mOlIr 14 1„ APPLICATION FOR'STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR PUBLIC.WORKS DEPARTMENT . . Permit No:. . TOWN HALL 1540 SUA.LNAN AVENUE; SOUTH WIN0SOR,CT 06074 FEE $2S 0 Name.ai Firm.. 7.. Address of Film ,Y _ ip Code Gt a'sr5- Location of proposed il►tprk �,, - :. R: . ic_ ..... a Describe fully nature.'of permit req A. v.. Starting date Ca(I Before You Dlg Na' .10 P 71 v p 1 f S r PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND.CURB REPLACEMENT IS A PREEIMINARY ESTIMATE. THE APPLICAN7iS RESPONSIBLE FOR THE FULL FINAL:COST OF THE PERMANENT PATCH AND OURS REPLACEMENT,INCLUDING ANY INCREASES .. PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN,' CONTRACT COSTS. THE PERMANENT PATC11fIS: TYPICALLY COiVIPLETED:'WITHIN.A YEAR OF THE TEMPORARY.PATCHBUT IT COULD BE LATEFI THAN.A YEAR. Check Applicable., EY.No Pavement,;:Curb or,Sl i*Ik Cut, [ Pavement Cut! ❑ ;purb Cut. ❑ Sidewalk Out Exi$tirig Driveway,No Changes' © Proposed Driveway Widening ❑ Proposed New Driveway Water Su Public Water. {3 _Well Sew? e.�. MCC' 1 ; Public Sewer Q.: Septic P.:.Y Show 8 etch of proposed work or furnish Indicate North This sscjign to be filled'out by Town.: two copies of separate drawing _ ; r .f r. . a a:, :.;Est:P ich.:Size(si) Est..Pvt Thickness in.: IEst.Patch:.Unit Price:$... sf EsfPetch CostA. Cur ' .e. b;;Est. Replacement ft Est..Curb,Unit.Prlce�I flf: Est.Curb Cosh" ..... Est.;sidiMilk°Replacement sfl i'Est Sidewalk UnitOrice.$ i. , .........: Est.Sidewalk.Cost$ .-- Est.TrafficH..ours.,- Est.Traffic Unit Gosf .,Est.Traff c:..C...ontmi 1k.., :;: �. Arn of Dsposft ....... ... Total Due SN - ( )Gash )...Check, 0 A. Applicant is responsible for contacting tha Police::Dept.and;C.B.Y.D: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES ` Paid$y:. . _ .. .AGREE 1O FURNISH TO THE TOWN OF SOUiH:1N.INDSORIHE AMOUNT OF BOND REQUIRED AND TO.REIMBURSE THE TOWN OF SOUTH WiNDSOR FOR ANY EXPEN$E5 INCURRED$Y THE TOWN FOR.MAINTENANCE..OR REPAIR WORK iN CONNECTION WITH'THIS PERMIT AND . THAT I AM FAMILIAR WITH AND WILL A, mr: BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED„IN THE TOWN:OF SOUTH WINDSOR'3 STREET CUT PERMIT MANUAL. Slgnecfs,� � -_ _ Print Natrte C 14 A,�;^���' � �.;�� Street Excavation Permit 2014 . Alwr ..(�.'. xa n3SSiTiak Mateo y - r.. f r e