HomeMy WebLinkAboutStreet Cut Permits 1 Buckland Road (6) 1.700225 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
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DATE: 10/25/2017
GIS ID.- 15300001
FEE: 50.00
MUNIS APPLICATION# 201701524
EXPIRATION DATE:
APPLICANT `;` LOCATION
NAME: EVERSOURCE ADDRESS 1 BUCLAND ROAD
ADDRESS: 112 PROSPECT HILL ROAD QVNBIt ONE B[ICKLAND CENTER LLC
EAST WINDSOR,C'T,-b5088 110 Lt1yENDER LANE
;$ OCIY HILL,CT 06067
PHONE
-
WORK DESCRIPTION: I Sc 2�BBUOKLAND RO►D ECAATQ15TALI: AS MAIN AND TWO
SERVICES WORKING IN -H SIDEWALK
APPLICANT AGREES TO FURNISH THE TOWNOF SOUTH WINDSOR THE-AM00 OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES IITGURRD>3Y I IIE T01�U1kFOR 1vIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THF,APPLICANT,;IS FAMILIAR 11I3 H AN'1 WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN'OF SOIUTH WINDSQR'S STREE,T CUT PERMIT MANUAL.
ISSUED BY DATE INS ECTED INSPECTED BY
10/25/2017 11:58 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: � a � CONTRACTOR: ' a rzt:�2.
LOCATION: I ` .�� �?�,�%��771 ' -�
TYPE OF WORK; l jl,S J Ij�AA /d"t U t :S
DATE INSP NEEDED: DATE INSP: Le
INSPECTED BY: 6A
WORK IN
PROGRESS; / lze vK o c �j i , n
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor INPSECrION REPORT 14
APPLIGATIUN 1-UK b I Ktt 1 tAC:AVA I IUr-J rt:KIV11 I
Appl, No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $50.00
Name of Firm_rJ E Pr 'sb u f-L6 Phone No.
Address of Firm 6 CV� ( F, ' lAA),Z'b Zip Code 060 8
Location of proposed work I !' k5 a fe Q< j# IUb JZ�_b
Describe fully nature of permit requested_,'C.#V ff -4 ID 6h s M h I A) ,d A)p 7-W6
c3 e cyl L( S o to ) 61<10 1 fo ' 'ti R '-51 ib F 1ru (-K .
Starting date O Z_ 3 Call Before You Dig No O I `7 t �
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT 1S A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut 0 Curb Cut Midewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch.of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
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 3ft 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 REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:.._ Print Name, �f� &�b L f-j9 HOM Date:
Engineering/permits/Street Excavation Permit 2017
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The material contained on this map Title:
shalt be consideredproprietary to
Eversource Energy and user(which is -
defined as any person or entity Q �► R(/�►who has received the map through 9 gy EVE■ S' U l4 1 VE
sale,purchase,exchonge,gift, or Information shown is not guaranteed and Evers Ener
otherwise)shall keep it in confidence assumes no responsibility. Contractors ore urged to call
and shall not furnish or disclose it Eversource Energy for further information of 1-•800-989-0900 ENERGY
to any third party without the priL. or
written permission of Evereo uce Energy. Plotted:18-act-21OP117 I By:gisewrt