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HomeMy WebLinkAboutStreet Cut Permits 8 Windshire Drive (3) 1700170 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 08/18/2017 GIS ID: 95100008 Y FEE: 25.00 EXPIRATION DATE: 08/18/2018 MUNIS APPLICATION# 201701103 hh APPLICANVT h " 5 LOCATION NAME: CENTRAL SEALINQX'17 INC ADDRE $ 48 i I?SHIRE DRIVE ADDRESS: 150 SUNSET RIDGED 'OWNER GERBf..,OLGA A EAST HARTFORD, DSHIRE DRIVE ` SOUTH WINDSOR,CT 06074 PHONE i WORK DESCRIPTION: DRIzUE�VA j APPLICANT AGREES TO FURNISH THIATOW I bP OiJTI 1 iN13 OR�IZE 1�MOI ITJOF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR A1IY YPEI�I 5..bi.-UI2 I $YTHE TQWI*j R�VIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND TFIE A P ACANT IS FAMITl1AIt WITH A TD WII L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OI SOT T CUT PERMIT MANUAL. ISSUED BY DATE Il1SPELTED INSPECTS BY 8/1812017I2:14PM *"* PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** s x13 5 s 7k�1W i tee t '�. 45 J 3 li too s 1 as, ti: r ::S f y' s r r `2 LK:; Y 4 74 ` �i.. TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO,: 1"700/'70 CONTRACTOR: ("f" Ira I LOCATION: 1 ALI 04 ►' 4 TYPE OF WORK: DATE INSP NEEDED: DATE INSP: ? INSPECTED BY: at) WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: -'" DATE: A 0 S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14 APPLICATION FOR STREET EXCAVATION PERMIT App€. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm _{� �ti _ {'GI t "A (C) 1 dVC- Phone No. ' Address of Firm 17D SLt v1 i a; k Py,. � �I CI T Otol SZip Code Location of proposed work Describe fully nature of permit requested (- (N-e Starting date I`7 Call Before You Dig No c7e PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut �xisting Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer © Septic Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing No.cuts Est. Patch Size(s) sf Est.Pvt.Thickness in. 3 s Est.Patch Unit Price y I Z I Est.Patch Cost$ Est.Curb Replacement ft Est.Curb Unit Price$ /ft Est.Curb Cost$ Est.Sidewalk Replacement sf Est.Sidewalk Unit Price$ 1st S Est.Sidewalk Cost$ Est.Traffic Hours hr Est.Traffic Unit Cost$ /hr Est.Traffic Control$ Amt.of Deposit$ Total Due$ ( ) Applicant is responsible for contacting the Police Dept.and C.B.Y.D ( )Cash Check# 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 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 OUTLINED IN THE TOWN OF SOUTH WINDSOR'S ST T CU�T/aERMIT MANUAL. I LA p Signed:� Print Name Date: flo Street Excavation� rmit 2014