HomeMy WebLinkAboutStreet Cut Permits 100 Windsorville Road (3) 1700012 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 02/16/2017
GIS ID: 95700100 FEE: 0.00
MUMS APPLICATION# 201700133 VIXPIRATION DATE:
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APPLICANT LOCATION
NAME: EVERSOURCE ADBRES$ �100%�VIDSORVILLE ROAD
ADDRESS: 112 PROSPECT HILL,xROL7 E. dWNER
GHILDREE GILBERT&JENNIFER
EAST WINDSOR,CT fl.088 6 HII TOWER RD
k ' SOUTH WINDSOR,CT 06074
PHONE i ti
WORK DESCRIPTION: INSTALL SASRVIGE TQ IEW H07E r 5
APPLICANT AGREES TO FURNISH THE xOWA1 OP SO�TTI3VINDSQR THE A1vI(SU1T OR BDND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A YEXPENSES INCTXRiEI?$ 'TIE TOW1 FORsVIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIIF.�tkPPd,ICANT IS FAIII IAR WI`I I AI1TD WIII ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN t3F SO J TH WIIcIDSOR',S STREET QIIT 15ERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
2/16/20I73:20PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: -7 f 0 ol. CONTRACTOR:_
LOCATION:
TYPE OF WORK: =
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN ,
PROGRESS:1.
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT:
S/molloy/forms 2014 Town of South Windsor IN13SEC1101 REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appi No TOWN'OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT permit No
TOWN'HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT.06074 FEE $25.00
4.
Name of Ffifii " ' 2-ZLI
on -No 0; .2.
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Address oftarlti
i Cade
Location of proposed uliclrtc t "'►:
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Describe fully nature of permit requ.fstd
Starting date Call Before You Dig No........ .
PLEASE NOTE: THE DEPOSIT FOR.THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB.REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN.A YEAR.OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ElNo Pavement,Curb or:Sidewalli Cut avement'`Cut..-:❑ Curb Cut CO Sidewalk Cut
❑ Existing Driveway,No Changes El Proposed Driveway'li eriiri ❑ Proposed New Driveway
Water Supply: ( P.ublic:Water ❑ Well Sewage$cftstf4 ;l. ❑ Public Sewer ❑ Seplic
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Show sketch of proposed work or furnish Indicate North Thls section td tie f111 J t tttt:l'tlilytt
two copies of separate�iratiniing
f No.cuts
i Patch Size(
l Est.Pvt.Thickness . in:
i Est.Patch Unit Price
I
� O Ark t7�5 Sever c� Est.Patch Cost"
'
_-. . . -
f Est.Curb Replacement..
:....._..:_ -..._ _.
Est.Curb Unit Price
E Curb "I Est.,Cur Cost
Est.Sidewalk Replacement
pj Est.Sidewalk Unit Price$ /sf
off" �� r�B1
Sidewalk.st E k Co - •:
; t•jSTl l�} �f ti (h- 'em ': Est.Traffic Hours
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'r 1� Est.Traffic Unit Cost$ Ir
I
I '—Est.Traffic Control$„
'Amt.of Deposit$
1 DRIVEWAYS must be 311: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 JOSSITE AT ALL TIMES 'G Paid By
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I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH
1NINdSQR:FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
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THAT I AMA-F It,IA13-WlTH AND WILL ABIDE BY THE RULES AND REGULATIONS.FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR' ;C.yT#kAMIT t++f�l l'`b-
I Signed: Print Names Date:,AL Q� .. _ e:
I Street;.; .;...a._itnTermit.2014.
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