HomeMy WebLinkAboutStreet Cut Permits 23 Woodland Drive (2) 1700138 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/28/2017
GIS ID: 96900023 FEE: 25.00
MUNIS APPLICATION# 201700810 EXPIRATION DATE: 06/28/2018
APPLICANT LOCATION
NAME: AIROLDI'S INC. ADDRESS: 23 WOODLAND DRIVE
ADDRESS: P 0 BOX 71 OWNER: POWELL RENEE M
SOUTH WINDSOR CT 06074 23 WOODLAND DRIVE
South Windsor,CT 06074
PHONE
WORK DESCRIPTION: DRIVEWAY
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.
/ y°+h
ISSUED Ut DAT INSPECTED INSPECTED Y
6/28/201710:27AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 13 CONTRACTOR:- 141 ro ;5
LOCATION: 23 1 d-au load br
TYPE OF WORK: 7 r l V e L012 i j
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: eD
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: c W\-- DATE: y
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR'STREET EXCAVATION PERMIT
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $25000
Firm Name of ` - Phone
. .
Address of Firm 0 Zip Code Gra O
Location of proposed workAA YX
- Describe fully nature of permit requested
Starting date 2. Approx.time for completion
Call Before'You Dig-No.'..":L§( 0 3 Existing Water Supply: ❑Public Water ❑Well
Existing Sewage:Service; Q Public Sewer [I Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND.OURB REP%ACMENLIS A
PRELIMINARY ESTIMATE. THE APPLICANT IS-RESPONSIBLE FOR THE FULL,FINAL COST OF•TkIE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS."THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing indicate North Town 61 South Windsor
No.cuts
Est.Patch Size(s) sf
t � Est.Pvt.Thickness in.
j� :Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price
Est.Curb Cost-$,
Est.Traffic Unit Cost$ fir
Est.Traffic Control$
Amt.of Deposit$
�-1�� Total rate s
)Cash ( )Check#.
Applicant is responsible for contacting Paid By
tl` P" ice.De t:and C:B.Y.D.
0.
i A TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TO
kOF SOUTH WINDSOR FOR ANY EXPENSES.INCURRED BY THE TOWN FOR MAINTENANCE OR f{EPAIR WORK IN
Com,ECTION WITH THIS PERMIT AND THAT 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OU NED T VTgWN OF SOUTH WINDSOR'S STREET.CUT PE MIT MANUAL.
Signed: ^4 Date,•
Title: Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR-ISSUANCE OF PERMIT
WORK•MAY NOT BEGIN UNTIL A PERMIT HAS13EEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL' MES
Street Excmtion Permit 08 REV 10-22-08