HomeMy WebLinkAboutStreet Cut Permits 32 Abar Lane (5) MI-I' I IWI'd rVI% %J I INL-L. I /-% [ 1v4e 1 0-1%Aw■1 i
'Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALLL,1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $50.00
Name of Firm )e� �cR �""J Phone No. �J- o-D9(o-4'
Address of Firm f2 Zip Code
Location of proposed work ADC-f Ln
Describe fully nature of permit requested
Starting date Call Before You Dig No 201 1
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: Cl No Pavement, Curb or Sidewalk Cut �I Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water []Well Sewage Service: ❑ Public Sewer [7 Septic
Show sketch of proposed work or furnish Indicate NDrth This section to be filled out by Town
two copies of separate drawing
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est,Patch Unit Price$ /sf
Est.Patch Cost$
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 aft 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 A0NDD� `
RREGU,LATIO OR PERMITS AS 0 TLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. i
Signed: Print Name�� � �`-�'���� Date:
Engineering/permits/Street Excavation Permit 2017
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32
The material contained on this map - Title:
1
Shall be considered proprielory to T i d e; 2
Eversource Energy and user(which is J
defined as any person ar entlly ■ /�'�'"'
who has received the map through �E G sale, purchase,exchange, gift,or 1i�} (b EVERS.9�YI. aV
otherwise)shall keep it in confidence 11 l .mil �^
and shall not furnish or disclose it ENERGY
to any third party without the prior ""aml."an shown is not guaranteed and E,-rsource Energy assumes no responsibility,
written permission of Eversource Energy. contractors ore urged to call Eversource Energy for further information at 1-800-989-0900 0 e• - U-