HomeMy WebLinkAboutStreet Cut Permits 105 Bourbon Street (2) 1700038 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
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DATE: 03/17/2017 ,.
GIS ID: 12300105 *`' FEE; 0.00
MUNIS APPLICATION# 201700240 ` EXPIRATION DATE:
APPLICANT LOCATION
NAME; EVERSOURCE \ AD15RESS 103'BOURBON STREET
ADDRESS: 112 PROSPECT HILVA F( SAD OWNfiR &URTI .ZUBRETSKY JEAN
EAST WINDSOR, CT 0�608$ 10 SOLIRBON ST
F ( UTH`' fNDSOR,CT 06074
PHONE
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WORK DESCRIPTION: GA$SERIOKINGR4lVf#30 DRIVLAY TO ACROSS
STRBE'I"IYZh
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APPLICANT AGREES TO FURNISH THE2TOWN D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN'Y kXPbg..F,�1 CGURRED BIB T.HE OWixTSkOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE 1..PP ICANT IS F°AI1 yIILIAR V XTI•I AIVD�JTI L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SQUT'H WINDS STREET BUT I��jt1V1IT MANUAL.
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ISSUED BY DA°I'E I StFETED INSPECT D BY
3/17/2017 12:09 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WENDSOR INSPECTION REPORT
PERMIT NO:: 7 �' CONTRACTOR:_
LOCATION: +�
YPE OF WORK: j--S
DATE INSP NEEDED: DATE INSP:' -
INSPECTED BY: 1l:
WORK IN
PROGRESS.. 6,1.5. c v-A, e a v,;t_
SEPTIC TANK PUMPED;SMASHED,FILLED WITNESSED ❑YES ❑NO
AS-BUILT
DATE._. •`
INPUT: '
S/molloyArms M14 Tom of South Windsor IlVKSMOlf REPORT 14 ""'
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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 $25.00
Name of Flan .:; Phone No-.
Address of Firlti : ' , '' 3f;•.. � a p 0,'WA-
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Location.of proposed+tugrk. t.,
Describe fully nature of perms#regtisid 11, i �`❑ ? h14 fi¢`"4 '_ _c-. c�' 'U 1 L. '
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Starting date ---� ^�, Call Before You DIg loci,2 0 It
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE.FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT'COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: 0 Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North his secri to ba fisted out 6r"foyi►rt'?
two copies of separate drawing
No.cuts
Est.Patch Size(io:' Sf
Est. Put.Thickness in:
Est.Patch Unit Price$ Isf
Est.Patch Cost$
Est.Curb Replacement
Est.Curb Unit Price —_—At;
Est.Curb Cost$
Est.Sidewalk Replacement sf.
Est.Sidewalk Unit Price$ Isf
Est.Sidewalk Cost'$
Est.Traffic Hours hr
Est.Traffic Unit Cost$,
Est.Traffic Control
Amt.of Deposit$ ..
DRIVEWAYS must be 3ft or more from the property line per Total Due$
section 217 of the zoning regulations
( }Cash ( }Check#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
PERMIT SHAD_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
WINDSOR's STREET CUT PERMIT MANUAL..,
Signed,,- ✓+- , , : Is,e, R� '- ' Print;N e. f j,(_O`L 4 *0 i' )24 Date: -3 ^ZO 7
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Street,Excavation Permit Z614
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