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HomeMy WebLinkAboutStreet Cut Permits 85 High ridge road (3) 1700142 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 06/29/2017 GIS ID:42300085 z FEE: 0.00 MUNIS APPLICATION# 201700819SBXPIRATION DATE: tiJ APPLICANT v ` � yy_ LOCATION NAME: EVERSOURCE r : ADDRE S 83rIIGH RIDGE ROAD ADDRESS: 112 PROSPECT HILT R,AD c OWNER CHAIf1 ONDA SRINIVASA&ARUNA EAST WINDSOR,(TGI60$-8 �8� IIGi RIDGE ROAD F PHONE S�?[7'IHWINDSOR, CT 06074 Y y � r :� ti WORK DESCRIPTION: INSTAbL W.WU GAS SER ICED SIN ANTI 115TA PRESSURE MOI4I 'RN G 0A'BINREAM- FT OF POLE 21370 APPLICANT AGREES TO FURNISH TH���O I�OF SOUTH Sh/XND$Ql� I E'AN�OGII�ITkOF$OND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AEI'1;XPEISES INQUi�RED 13 ' E TOW1�T FO�•IvIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND ThE APPLICANT IS FI,IARf`I"H D`1?1'$LL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN"' SOiJTH W11TDS0&':S STREIITi1T PERMIT MANUAL. IS UED BY DATE IITSPE'CTED INSPECTED BY 6/29/20172.07PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** s r , b 47 F1 b• ( i N �L ,�, C VS43 .F 4 4 y v F 5 l { : ,z TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: /"7f7Q CONTRACTOR: -rne LOCATION: TYPE OF WORK: C . Z �� '� ✓ C sp ©f'- Gu ,54-c- DATE INSP NEEDED: DATE INSP: 3 INSPECTED BY: U-l) WORK IN PROGRESS: IUe,z S : 'v' ✓�'lc�•h e SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: q) S/molloy/forms 2014 Town of South Windsor INPSECTION 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 $25.00 Name of Firm Eversource Gas Phone No. 203-596-3047 Address of Firm 112 Prospect Hill Rd Zip Code 06074 Location of propoAW6@0 High Ridge Rd, South Windsor, CT - ;yj 6��_j Describe fully nature of permit requested Install new gas service on main and install pressure monitoring cabinet at the end of cul de sac on the left of Pole 21370 Starting date 7/10/17 Call Before You Dig No 20172602930 PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑ No Pavement,Curb or Sidewalk Out ® Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut ❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing No.cuts N t Est. Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price$ /sf x Est.Patch Cost$ Est.Curb Replacement ft Est.Curb Unit Price$ /ft 8 dg Est.Curb Cost$ Est.Sidewalk Replacement sf Est.Sidewalk Unit Price$ /sf Est.Sidewalk Cost$ Exisdng 2" Est.Traffic Hours hr 1PROPOSED 1/2"Z ULMETER SERVICE Est.Traffic Unit Cost$ /hr f Po1.21376 PROPOSED REMOTE MOM ORIxc warm Est.Traffic Control$ 30"X 17"X 76" Amt.of Deposit$ DRIVEWAYS must be aft or more from the property line per Total Due$ section 2.17 of the zoning regulations O 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 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: /l��eA Aa' 4 - � Print Name Nicole Karinchak Date: 6/28/17- Street Excavation Permit 2014 Confirmation and Call Before You Dig CT so�hK. www.cbyd.com T` Mark out Check-list Call811 &Ticket # Excavator Details www.cbytl.culrr Contact: Miss Nicole Karinchak Caller Id: 40189 47 Eagle St Ph: 203-596-3047 Address: 9 Waterbury Cell: 845-926-8829 Email: nicole.karinchak@eversource.com Fax: Not Supplied Dig Site and Ticket Details Ticket Type Routine User Reference Woodland Telemetry Ticket Date 06/28/2017 12:37:27 Work Start Date 07/10/2017 + ,'tr ii �v i yt t, a n r h-S r s��I <� r < �}{ Er �z�,� �� , J:i�y{.�a�'i j Ticket Expiry <17/28/zo17 '2� � �' r �� 1I `Ir 9 High Ridge Road SOUTH WINDSOR �, f fink SpJS } Ah a Address ./ i21 14 r s' yt2�a ���yatk�� t�`���Q S�x�M Gas � r x ," KM 1 Type of work Other iNFj-' _�'# '' Machine Exc y,g��� r � � Location of .•;, t �? �r. Roadway er ,< � i �x � y� Workplace -V4 Location in Road Road R.O.W.,Sidewalk,Shoulder � �- "'.� �� rr-i �� � Excavator Eversource Gas �tia 144 ���� , , u �,� ��, Is Pre-marked YES I �s l � Cross-Street glenwood p, a fix. Notes/ Description of works vOR Ott _ �xs{ Gas excavation work Is directly east of Pole 21370.The remote monitoring stand will be placed directly east of the pole on the east side of the road.The vz'tjas service will be installed from the 2"gas main on the east side of the road to the e metering stand. Your 1 i Responsibilities Do not proceed with any excavation until all Public Utility owners listed have marked out their facilities or have contacted you directly. .Ensure you adhere to any State legislative requirements regarding safe digging requirements. .If you damage an underground Public Utility you MUST advise the Public Utility owner immediately. For more information on safe excavation practices,visit www.rbyd.com Utility Owner Details The Public Utility owners listed below have been requested to mark out the location of their facilities. Please note they may contact you directly to clarify any aspects of your ticket. CONNECTICUT WATER COMPANY 1-800-286-5700 1-800-286-5700 NOTIFICATI Y/N ON SENT COX COMMUNICATIONS 800-598-0628 800-598-0628 NOTIFICATI Y/N ON SENT EVERSOURCE ELECTRIC 800-778-9140 800-778-9140 NOTIFICATI Y/N ON SENT EVERSOURCE GAS 203-317-4501 800-942-7529 NOTIFICATI Y/N ON SENT FRONTIER COMMUNICATIONS 1-800-598-0628 1-800-598-0628 NOTIFICATI Y/N ON SENT TOWN OF SOUTH WINDSOR 860-644-2511 x344 860-644-2551 NOTIFICATI Y/N ON SENT END or UTILITIES LIST o tl . o • . . Ona Ca40.cass-Pov.ersd by FdlanCorp