HomeMy WebLinkAboutStreet Cut Permits 169 Brookfield Street (3) 1700081 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/15/2017
GIS ID: 14700169 = FEE: 25.00
MUNIS APPLICATION# 201700526 ;5 IkXPIRATION DATE: 05/15/2018
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APPLICAN LOCATION
NAME: JIM FAUTEUX CONO"Tt ;� ADDRESS 1�9"BffOOKFIELD STREET
ADDRESS: 221A SCANTIC ROAD;:, " QWNI:R T,AYI;OR DANNY C&CLAIRE P
EAST WINDSOR,CT 06088 159 IRtJOKFIELD STRE
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SOUTH WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: RERLA(✓E STDEWAI�K,. s r a
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APPLICANT AGREES TO FURNISH THF};TOWN OF SOUTH'WINI Ism iTHE AMC 1INTtOF BAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AiIY;EI'E1�ISI;S INCU A&Y TIDE TQWF FbI�1�1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T1IE APPLICANT IS 1�.MI IAR WITH A�•11��II L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN SOUTH VCINI�SOIt'S STREET CUT 1�ERMIT MANUAL.
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ISS D BY DA` E= -SPECTED INSPECTED BY
5115/20I79:15AM ***PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO- D CONTRAMR: IDS 7 G a
LOCATION:
TYPE OF WORK'.—
DATE INSP NEEDED: DATE INSP: I fy
INSPECTED BY: ;t
WORK IN
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PROGRF.SSo :L,> 4' •w, . �i �'�ti� ,:X� .
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SEPTIC TANKPUMPED,SMASHED,FILLED WffNF.SSED ❑YES 0 NO
AS-BUILT: .�
INPUT: DATE:
S/mollw/°f dorms 2014 Tom of SWth Windsor MPBWWi+T'RE OU 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 FETE $25.00
Name of Firm 1 /'L. r3 G( � � a 5 f J f` Phone No. 6
Address of FirmCG1t�'1 P' r.. �n�Sd r Zip Code
Location of proposed work 16 T Coo f J 56V n1k1f
Describe fully nature of permit requested 1' (ate, 6 j><
Starting date .5 / / Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut 93 Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled outby Town
two copies of separate drawing
No.cuts
i
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
')' Est. Patch Unit Pr'tce$ /sf
t'f Est. Patch Cost$
Est.Curb Replacement it
Est.Curb Unit Price$ ffi
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
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.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 FOA MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT I AM•FAMIMA.R WITH-AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERWTS AS OUTLINED IN THE TOWN OF SOUTH .
WINDSOR'S TREETCUT RMI�.'
Signed: _ ✓ ,i print Name —� Date. �/10//