HomeMy WebLinkAboutStreet Cut Permits 125 Diane Drive (2) 1700228 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 10/31/2017
GIS ID:28200125
MUNIS APPLICATION# 201701560 N s FEE: 50.00
i EXPIRATION DATE:
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APPLICAN .s y LOCATION
NAME: EVERSOURCE ADDRESS I2YDr NE DRIVE
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ADDRESS: 112 PROSPECT HILLS IUD' 3 = OtNERYiiG. JACK W&MARILEE R
EAST WINDSOR,CT 06(}88 DIANE DRIVE
u SOUTH WINDSOR,CT 06074
PHONEJ.
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WORK DESCRIPTION: INSVR P STI PIP TO ALREADY T'kNO TEEL PIPE WORKING
FRO !Ih<ITTIjRSTIQN;TO kR�ONTLFICIE �7
APPLICANT AGREES TO FURNISH THIN!'OWN Ok`SOLT I T1*�I?SOQ THE AIvIOr fVTkQ I3i ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ATVI EXPENSES INCj7RRIIY THE 3' W1T FORIvIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TTT APPLd ANT.IS&*A�II�IAR Vl?[T�I AND�i?II L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN bF SOFJ H WIIVDSQI 'S TREATIT MANUAL.
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ISSUED BY DA E` SPEaCTED INSSPPE TED BY
1 0/3 11201 7 3:33PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1*7 C4,4,q CONTRACTOR: UZ4_50 or _
LOCATION: 1
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: 1
INSPECTED BY: �
WORK IN
PROGRESS: L�
SEPTIC TANK PUMPED, SMASHED, FILLED-_,--WITNESSED ❑YES [] NO
AS-BUILT;
INPUT: DATE: }-1 1 19
S/molloy/forms 2014 Town or south Windsor I pswr ON 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 $50.00(', �4ML
►'Name of Firms Phone No.
Address of Firm v Zip Code 00
Location of proposed work I R5 i i
Descnb fully nature of per it requested V l rl
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Starting date ID 5 1 l-7 ali Before You Dig No v t
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut A Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No. cuts
Est.Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
1
Est.Curb Replacement ft
Est.Curb Unit Price$ Ift
Est.Curb Cost$
( 4, Est. Sidewalk Replacement sf
st. Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
il Est.Traffic Unit Cost$ /hr
{
Est.Traffic Control$
j Amt.of Deposit$
DRIVEWAYS must be 3ft or more from the roperty line per Total Due$
section 2.17 of the zoning regulations -
O Cash O Check#
Applicant is responsible for contacting the Police Dept. and C.B.Y.D
PERMIT SHALL BE KEPT QN 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 TCWN 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
j WINDSOR'S ST T PERMIT MANUAL.
Signed: Print Name All Date:
Engineering/p rmi /Str t Excavation Permit 2017
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sale,has received
exchange,gift, or Information shown is not guaranteed and Eversource Energy +
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to ahy third party without the prior
written permission of Eversouce Energy. Plotted:19-Oci-2017 By:ginawrt