HomeMy WebLinkAboutStreet Cut Permits 138 Gail Lane (2) 1.800045 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/08/2018
GIS ID: 34500138XFl
MUNIS APPLICATION# 201800632 �{ ~7 FEE: 50.00
EXPIRATION DATE: 05/08/2019
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APPLICANT P`{ LOCATION
NAME: AIROLDI'S INC. �� fi ADDRESS 138MGA}IL LANE
ADDRESS: P O BOX 71 2,
a OW1`1E t'1LAE&EA JOSE A&
SOUTH WINDSOR eC� 614 ti
Z $=GAIN.LANE
VT WINDSOR,CT 06074
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PHONE
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WORK DESCRIPTION: DRIA/EW,AY i� s. OVE AND I2E#�T,AC f'
APPLICANT AGREES TO FURNISH TH>J`7TO:WN OF SOiI73 WINDSOK TIDE;4MOiT Q $AND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AI iY.E Q'ENSfiS�CLIT Bit gI$TO WNSFOR�VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WNb SOUTH 1 .'" SO 'S STI ET CUT P 1tMIT MANUAL.
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ISSU B D` TE 'SPECTED INSPECTED BY
5/8/20189:I8AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l UD y CONTRACTOR: '1 / �S -
LOCATION:
TYPE OF WORK: D,,)UP
DATE INSP NEEDED: DATE INSP: �Z/
INSPECTED BY: A
WORK IN
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PROGRESS: S t.� `�r J✓ ems
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: DATE:.. ,
S/molloy/forms 2014 Town of South Windsor INPSECMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:V ' 4-
SOUTH WINDSOR, CT 06074
FEE $$� �.r a
Name of Firm Phone No.
Address of Firm IS). a Zip Code
Location of proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion Z EF
Call Before You Dig No. Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
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
i iENG�H,TRAFFIC CONTROL AND THE TOifVN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ mr
Est.Traffic Control$�_
Amt.of Deposit$
Total Due$
( )Cash ( )Check#
'Applicant is responsible for contacting Paid By
the Police Dept.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 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 OUTLINE IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: A—�Arb
...............
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Title: 1# " fix Driver's Licepse#:
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 Excavation Permit 08 REV 10-22-08