HomeMy WebLinkAboutStreet Cut Permits 191 Hillside Drive (2) 1700233 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 11/16/2017
GIS ID:43800191 FEE: 50.00
MUNIS APPLICATION# 201701642 EXPIRATION DATE:
11
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APPLICANT $t LOCATION
NAME: EVERSOURCE ADDRESS I91 HILLSIDE DRIVE
ADDRESS: 112 PROSPECT HILN ROAp C3 NER LARUE ALBERT A&SEENA L/U&
EAST WINDSOR,CT 06tf8�8 ` 1'91 HTTLSIDE DRIVE
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PHONE t :1 SOUT1 I yVINDSOR,CT 06074
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WORK DESCRIPTION: INSIsLArERV1E IN FRONT OF 194 GOII�TG�T'Q RIGHT SIDE OF
191 " 441,
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APPLICANT AGREES TO FURNISH THE�y'TOWN OF SOUTH V�I1�7D$UTZ THE1VIOI]1T 0 BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN,Y LXPEN ES INCUFM B1''IHE TOWN FSJR:1�IAINTENANCE OR REFAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE PLICANT IS FAMILIAR VT14i AL+I. WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFFCI;)TH WIIVDSOR'S BTRRET GUT PERMIT MANUAL.
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ISSUED BY ' DATE INSPECTED INSPECTED BY
11/16/20171:55PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: / 7 CONTRACTOR: VA ��
LOCATION: II Ole, J) &L&=!��
TYPE OF WORK: t .5 enj
DATE INSP NEEDED: DATE INSP: t
INSPECTED BY:
WORK IN
PROGRESS: Im,l` 7``; °
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: (,V— DATE:
S/molloy/forms 2014 Town of South Windsor INPSECfION 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 06074E�>
Name of FirmV - Phone No.
Address of Firm I 1 5 Zip Code r7(,P
Location of proposed work
3a� 'Sy�co C1
Describe full nature of permit requested V l f
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Starting date Call efore You Dig No rRn� 2)
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
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑Proposed New Driveway
Water Supply: El Public Water ❑Well Sewage Service: ❑ Public Sewer Cl Septic eF7.':7'3- fIR
Show sketch.of proposed work or furnish Indicate North This section to be filled out_bTown
two copies of se`larate drawing
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness _in.
Est.Patch Unit Price
Est.Patch Cost$
4
Est.Curb Replacement ft.
Est.Curb Unit Price$ /ft
3
Est.Curb Cost$
i Est.Sidewalk Replacement s€
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
C6 (J T Est.Traffic Hours hr
t 3 771 Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
DRIVEWAYS must be 3ft or more from the prope tine 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 JOSSITE 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
EXPENSErtree
OWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY
THE RULEOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Print Name Date: 11 aIj
Engineerits/
ation Permit 2017
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defined as any person or entity - R(/�►who has received a the mop through EVERS..-U■\VE
sale, purchase,exchange,gift,or Information shown is not guaranteed and Eversource Energy
otrierwise)shall keep it in confidence assumes no responsibility. Contractors are urged to call IRAC ENERGY
and sholl not furnish or disclose it Eversource Energy for further information at 1-800—g89—ogoo
to any third party without the prior _
written permission of Eversouce Energy. Plotted:03—Nov-2017 By:gisewrt