HomeMy WebLinkAboutStreet Cut Permits 1096 Ellington Road (2) 1800163 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 10/25/2018
GIS ID: 30301096 FEE: 50.00
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MUNIS APPLICATION# 201802109 IRATION DATE: 10/25/2019
APPLICANT
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NAME: METROPOLITAN DISTRACT
IDES 1b ELI;INGTON ROAD
ADDRESS: 125 MAXIM ROAD v r QWNER E' RE�SNK
STREET STE 21850
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HARTFORD,CT 06114
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WORK DESCRIPTION: BOX
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APPLICANT AGREES TO FURNISH THE TG?W 60 OUTHM-1) C?R T E1A1 OUNT Or I BONII&EQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN �.ENSES ITTCj.iURRED� �THE TOWN F�IiNL1ITTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THOU fT TS FAMI7x�R WITH Ali)WII IP IDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN Ole SOUTH WINDSOR'_S;STREET UT:PE1ffl''MANUAL.
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ISSUED BY NSPECTED BY
10/25/2018 1:08 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR'IMSPECTION REPORT
PERMIT NO. 06 CONTRACTOR:
LOCATION: le26,
TYPE OF WORK:___o
DATE INSP NEEpED:�, • -_.- . DATE INSP r /
INSPECTED BY:
WORK IN
PROGRESS: '` ' `
SEPTIC TANK PUMPED,'SMASHED, FILLED WITNESSED ❑YES C]NO'
AS-BUILT:
INPUT: Lvi) .: DATE:
S/mogoy/OM 2014 Town ofSouth W Adw-IMPS&&%*ttr 6grt4
?AD-039,Revzn2 THE METROPOLITAN DISTRICT- PAVEMENT CUT DATE: .�" "��
ADDRESS �. G� '' BILL JOB ❑YES G'106— WO# SS 7I7i�'�'
CLOSEST STREET j, el I1-7V, TOWN S7 ,'-, STATE HIGHWAY ❑YES ffO
DRAW SKETCH SHOWING LOCATION AND/SIZE OF CUTS AND CUT MADE IN
CROSS SECTION OF PAVEMENT
❑STREET ❑BITUM._" ❑CONC.-" CIPREMIX "
'❑SIDEWALK ❑eITUM. " ❑CONC.-" ❑FLAG
El CURB ❑B(TUM.-' ❑GONG,__ __' ❑STONE_'
/ ❑DRIVEWAY ❑BITUM._ ❑CONC. "
2tG ASS LOAM&SEED NEEDED ff ESQ ❑NO
REASON FOR CUT:
DEPTH OF EXCAVATION; / 5
° }} NUMBER OF CUTS:
CI DATE OF FIRST CUT:
IS JOB COMPLETED: /15S ❑NO
FOREMAN:
REPLACEMENT PAVEMENT CONTRACT INC.:
BITUMINOUS ❑ CONCRETE❑ PREMIX 0
DATE COMPLETED'^
ACCOUNT NUMBER:
CALCULATIONS
QF CUT ITEM# ITEM# ITEM# ITEM
PAVING INSPECTOR CONTRACTOR
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