HomeMy WebLinkAboutStreet Cut Permits 152 Edgewood Drive (2) 1700234 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 11/27/2017 "
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GIS ID:29400152 FEE: 50.00
MUNIS APPLICATION# 201701679 EXPIRATION DATE:
Y
APPLICANT N LOCATION
NAME; EVERSOURCE AF ADDRESS 152 EDiEWOOD DRIVE
ADDRESS: 112 PROSPECT HILI1 ROADCOSTAzItUI&AMY
EAST WINDSOR,C 408s 152 EEWOOD DRIVE
SOZTTH WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: GASI SHAV-1CF REPLAO MENT ;
APPLICANT AGREES TO FURNISH THEE OVEN OF 9,0UTlI WINDSOiI TIDE AMOUI TOZ'BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANYXPE1fTS1✓S INC,CIRRED EY TIC TOWI*I;FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND Th.APPLICANT IS FAIVLTI IAR WIT H AND WII L ASIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH W�NDSOR'-S STREE`I Gi IT PERMIT MANUAL.
ISSUED BY DATE`I1VSI'ECTED INSPECTED BY
11/27/20I72:18PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: V1 nth,)3LI CONTRACTOR: ' P(e5n�a►�C.f? _
LOCATION: 1-�7 a S'_J a rU,)06d
TYPE OF WORK: U }
DATE INSP NEEDED: DATE INSP: 1 3 0
INSPECTED BY:
WORK IN
PROGRESS;
a j -e c� 4 el.1 -J o, S, ,
SEPTIC TANK PUMPED, SMASHED, FILLED - WITNESSED ❑YES El NO
AS-BUILT:
INPUT: GI Tlj--- DATE: .
S/mo!!oy/forms 2014 Town of South Windsor INPSEMON REPORT'14
. AFFLIUATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WQRKS DEPARTMENT
1540 SULLIVAN AVENUE Date:r�
SOUTH WINDSOR,CT 06074
FEE .ft 0 C2
Name of Firm fax SO uez Phone No. �®`` 4 _���
Address of Firm i 1' Zip Code
Location of proposed work_,'
Describefully nature.of permit requested ,6P�'S _5,yZL/fGr (LuL, cL,,xfioT,
Starting date Approx.time for completion
Call Before You Dig No. Existing Water Supply: [I Public Water ❑Well
Existing Sewage Service: []Public Sewer ❑Septic
PLEASE NOTE:.THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH ANI)CURB REPLACEMENT IS A
1PRELIMINARY 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`$CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN"EAR OF THE TEMPORARY PATCH BUY'IT COULD BE LATER THAN A YEAR.
Show sketch ot'proposed work or furnish Thls sectiono bg filledti
two copies of separate-drawing Indicate.North Town of South Windsor
No.cuts
Est Patch Size(s) sf
Est.Pvt.Thickness In.
Est.Patch Unit Price$ /sf
--�` Est Patch Cost S
Est Curb Replacement ft
Est Curb Unit Price$ flt
Est.Curb Cost$
Est,Traffic Unit Cost$ /hr
Est Traffic Control S
Amt.of Deposit
Total Due S
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police.De t.and C.B.Y.D. `
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 6Y THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL.ABIDE BY THE RU.LES.AND REGULATIONS FOR
PERMITS OUTLINED IN TH TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL,
Signed Date:CL
l
Title Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Ekcavation Permit 08 REV 10.22-08
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The material contained on this map Title:
shall be considered proprietary to
Eversource Energy and user(which is - ,�,
sole,defined purchase,
any person or egnlity g - EVE RS=URGE
who hog received the throw h Information shown is not guaranteed and Eversource Energy
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sole, urehase,exchange, ift, or 9 9Y
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 at 1-800-989-0900 ENERGY
to any third party without the prior
wrilte,,permission of Eversouce Energy, Plotted:06-Nov-2017 I By:gisewrl