HomeMy WebLinkAboutStreet Cut Permits 203 Bourbon Street (6) 1700230 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 11/01/2017 .
GIS ID: 12300203t PEE: 50.00
MUNIS APPLICATION# 201701 S69 '> EXPIRATION DATE:
APPLICANT ;} f ,� h 4k LOCATION
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NAME: EVERSOURCE M� � r Y ADDRESS 26YBOURBON STREET
ADDRESS: 112 PROSPECT HILL 9IMMONS MANUEL U JR&CLAUDIA R
EAST WINDSOR, N 123`SEgTH TERR
rCA E C�pRAL,FL 33904-3424
PHONE ;
V-00 K i t r t y i t i
WORK DESCRIPTION: Exgm,1IN r 1 X1���AC TIOLE TQ` NSA ►L1JUSST S ATION ON GAS
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APPLICANT AGREES TO FURNISH THEOU1�J a1+90UWlfO AM(7CT 0 BbND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR Al YeI✓�{PEN$I S II`I U 1;I BY HFjkTVVAF6kj4AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TiFAP �� AI�T I$YFA€VIII2AR V�TII AIaFA ?iI L ABIDE 13Y THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 0SOUGH W�NDSOR' STid" GUT PERMIT MANUAL.
ISSUED BY DA' E ftPECTED INSPECTED
I1/I/20173:24PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: 1J` -Ll oc )f--LQ
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: i�'
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES 0 NO
AS-BUILT:
INPUT: j,w� DATE WA
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
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 $50.00
Name of Firm 1�0 ace Phone No. aO-SZ,O- �D
Address of Firm l Zip Code
Location of proposed.work
Describe fully nature of permit requested x i
Oy(
Starting date Cap Before You Dig No a Lo00 �}
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: �No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
El E)dsting Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: CI Public Sewer ❑ Septic
Show sketch_of proposed work or fumish Indicate North This section to be filled out by Town
two copies of separate drawing
YYl�� No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
DRIVEWAYS must be aft or more from the property line per Amt.of Deposit$
section 2.17 of the zoning regulations
Total Due$
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES ( )Cash ( )Check#
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 RE ULATIONS FQ MITS AS OUTLLIIJED IN THE TOWN OF SOUTH WWIIN'DSOR'S ST T CUT PERMIT MANUAL.
1, 1 I
Signed: 4 Print Name �J �r d Date: �C) v'i
Engineering/permits/Street Excavation Permit 2017
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1:250 1-20.8' 41.7'
The material contained on this map Title;
i t I e 203 ®�
shall u considered proprietary to I
Eversource E Ye and user through
igh is E ,E RS V�U RC E
defined r an .1, or e i A , . I �®� \v`
who"as received the map through- `Fes, AI',.,[I `Yn\,J)
sale, purchase, exchange, gift,or
otherwise) sha11 keep it m confidence ENERGY
and shall not furnish or disclose it
"to any third potty without the prior Information shown is not guaranteed and Eversource Energy assumes no responsibility.
written permission of Eversource Energy. Contractors are urged to call Eversource Energy for further information at 1-E00-989-0900 4 e; — 7—
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The material contained on this map Ti I e: / l�shall be considered proprietary to 2_ "'JJJ Eversource Energy and user(which is •AIM
defined as any person or entity �^ �I `�"�►� l/"�
who has received the mop through ��I s o E E V 4W V'
sale,purchase,exchange, gift, or J
otherw se)shall keep it in confidence ENERGY
and sholl not furnish or disclose it
to any third party without the prior Information shaven is not guaranteed and Eversource Energy assumes no responsibility
written permission of Eversource Energy. are urged tc call Eversource Energy for further information at 1-800-9 9-0900 d g; —Oct—
Contractors