HomeMy WebLinkAboutStreet Cut Permits 136 Pine tree lane (2) 1700184 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/29/2017
GIS ID:72300136 FEE: 25.00
MUNIS APPLICATION# 201701147 ♦ y EXPIRATION DATE: 08/29/2018
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APPLICANT a ° ,± 5 LOCATION
NAME: QUALITY PAVING GAO t . ADDRESS 1 -6PINE TREE LANE
ADDRESS: 194 S.MAIN STREET' t t OWNER I?ATR SSI JULISKA M L/U
EAST WINDSOR,C;�'�Q608$ r I�� TREE LANE
r f S�UT�I UVINDSOR,CT 06074
PHONE 860-523-4182 z
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WORK DESCRIPTION: DRVE< A,',
APPLICANT AGREES TO FURNISH THE& OWN OF SOUTH WIND ER TIM AMD7INT QF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WWDSOR FOR AIWK7MMN,U.N.II Ctip, EEf7 BY T IE TOWI'FOI?s vIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T1IE.9.PI?�,�CANT I..S FEIMIJIAIZip WIC L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 01F SOC]TH WIND OR'S ST)EET CUT PERMIT MANUAL.
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ISSUED BY DA E INSPECTED INSPECTED BY
8/29/2017 3:00 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 00 1 CONTRACTOR:_Il I m I r�
LOCATION:__ 122
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: p4"
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [ NO
AS-BUILT:
INPUT: DATE: 'r Cn re
S/molloy/forms 2014 Town of South Windsor IMPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. NO. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HAPL—W10 SULLIVA VENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firmj571174 Phone No.
Address of Firm U �r✓= Zip Coe
Location of proposed work '
Describe fully nature of permit requested
Starting date ` G-/7 _ Call Before You Dig No C')` �
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD-BE LATER THAN A YEAR
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut 17 Sidewalk'Cut
J2'Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: 11 Public Water ❑ Well Sewage Service: Ci Public Sewer ❑ Septic
Show sketch of proposed wo fu h Indicate North This section to be tilled out-by-Town
two copies of separate in A�
No.cuts
nA
Est.Patch Sizes) sf
Est.Pvt.Thickness In.
Est.Patch Unit Price$ Isf
u Est,Patch Cost$
Est.Curb Replacement ft .
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Est.Curb Unit Price
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ Isf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ Ihr
Est.Traffic Control$
Amt.of Deposit$
DRIVEWAYS muat:be aft or more from the property line per Total Due$
secdon.2.17 of#hizoning regulations
{ )Cash { )Check#
Applicant Is responsible for contacting the police Dept.and C.B.Y.D
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,FAM114AR;WITH�AND WILL ASIDE BY THE RULES AND.REGULATtONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S STREET CLlT PERMIT MANUAL.