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HomeMy WebLinkAboutStreet Cut Permits 47 Patria Road (3) 1700101 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 05/31/2017 GIS ID: 69900047 FEE: 0.00 MUNIS APPLICATION# 201700631 EXPIRATION DATE: APPLICANT LOCATION NAME: EVERSOURCE ADDRESS: 47 PATRIA ROAD ADDRESS: 112 PROSPECT HILL ROAD OWNER: VALLEY HOLDINGS LLC EAST WINDSOR,CT 06088 47 PATRIA ROAD SOUTH WINDSOR,CT 06074 PHONE WORK DESCRIPTION: EXCAVATING 1-PX1'VAC HOLE TO REPAIR TEST BOX&WIRES ON GAS MAIN 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. C- Mr,IIyN q /11117 ", ISSUED BY DATE INSPECTED INSPECTED BY 5/31/2017 3:13 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO:: % l 0g2/d-/ CONTRACMR: F LOCATION: H -7 ?art C-i A ��,,�cj TYPE OF WORK. JAL, 11 eel e -rl) reap-1 2 5S` DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS; • e, � s C` �� Y all- SEPTIC TANK:PUMPED;:SMASHED,FILLED WITNESSED ❑YES ❑NO AS-BUILT: INPUT: 1( DATE: ' S/moitoy/fnmFs 2014 Town of South Windsor INPSECTI ITWORT 14 _ . - AT Appl.No. I TOWN OF SOUTH WINDSOR Permlt No. PUBLIC WORKS DEPARTMENT3�r ` _:.1540r61 .L AN Ai/-ENUE - Date: _.,. SOUTH WINDSOR,C-T,00074. FEE $25.00 Name of Firm P'no r CP Q Phone No. D�ci�~aQ(p Address of Finn wjIp tide Location of proposed work !"_ ftsor fully natare of permit requesfed 'K. t */GkA A� Starting date: — -a Approx.time for completion. Call Before You Dig No. 2l3 v Existing Water Supply: ❑Public Wa er ❑Well Existing Sewage Service: ❑Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE'LATER°THAN A YEAR. Show sKetch of proposed wotk or furnish is section to lac I I+taut by two ctiples of separate drawing Indicate North o IE 1AF1 ndsor No.cuts 0 Est.Patch Size(s) sf Est.'Pvt.Thickness in. Est.Patch Unit Price /$f Est.Patch Cost$- Est.Curb Replacement It Est.Curb Unit Price:$ Est.Curb Cost Est.Traffic Unit Cost$ /hr Est.Traffic Control Amt.of Deposit$ Total Due$ ( )Cash ( )Check# Applicant is responsible for contacting Paid By the Police Dept.and C.B.Y,Q,_. 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 OUT`LWED THETOWt�1W WINDSOR'S STREET CUT PERMIT tt MANUAL. Sign Date' 5 3 t ' Title �' � -C�.[ tt!1 I i 1.6. Driver's'Ucense# itU tale ' PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED PERMIT SHALL'BE'KEPT ON JOBSITE AT ALL TIMES Street Excavation Permit 08 REV 10-22-08 J� f r 47 'r sf FF yy++}} J 1 JJ J J I 0-- 0 50-sox# 03 _ .� .,.r The rroteria{c9nta,red on this Wp . _. Tit�B».::. iL�{' '►/"'J� ` (n/ c}]�`,�yA► n �• s�alf,4a etsldwed I I Y 1 ` l - ' ` �"` `' 1 ytnclso {j rSser daflgat�as ar . ENERGY atad`iit,t�i rant Lnrre ar disclaaaa+6�e _ . atharivrrta)etuali'���in svaaficZeca ,� to any third party vre'ihplt�f#ae pntrr inPom,otion shown rs of guaronteed and£renoource Energy assumes no res wn#ten permission of EviStsuurre Energy. Contractors ore urged to oatt Eversource Enerfi'f�further,nfotmotion at if8 - g—' g- qij(+- n pars bAi I' h d 47 ' 1 Lo f� r J' i` i L}' S©—LOy# I CY1 the motenai�onkained on khis map -ee tit , Title: BvatasrCA and!,�a(rdtk+is ,++� �ktirted ss a ae entdy EVERS CE wYac ha+ tht h ENERGY q d 9�tg11 4e di�{^Ni9�OrQ Informoti—ahorm is not guaranteed and EMeFaource Energy,osxumes no respens�b7ii m""�" atha�rtreu? ik f�'%arl/ld�tes ty Ihr_ 'controctom ere urged to call Ewmumo E,eargy'fnr further anfannaGon at 1-8a0-984-09a0 wri3taar Ritufaiais of f veouace lltugp• Q e: —may -