HomeMy WebLinkAboutStreet Cut Permits 566 Pleasant Valley R (2) 1800161 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 10/25/2018
GIS ID: 72900566 f FEE: 50.00
MUNIS APPLICATION# 201802107 EXPIRATION DATE: 10/25/2019
sj
APPLICANT r 7i _y Y �; N{ w 3 4 LOCATION
NAME: METROPOLITAN DISTRICT-.AX DRES S6b PLEASANT VALLEY ROAD
ADDRESS: 125 MAXIM ROAD OWNER S NGI ill, IN DERPAL&
IMF
566 PIASsANT VALLEY RD
HARTFORD,CT 061141 � €
PHONEbom
s
WORK DESCRIPTION: 12"MAINvig It
or
`r
APPLICANT AGREES TO FURNISH THE TQWh11I OI�FOU Ilk ViIIID�QRHE�AJ1[( JNT bF SONIfyREQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI� �PE�1�$S INCIIR�E�-BI�THL�TOWN�OR MAI��ITENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE-0 i 16&IS FAMI L WITH ANI W 'ABIDE$Y THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OSOUTH WINPSOR'S STREET CUT; ER1vIIT'MANUAL.
ISSUED B DATE SPCTD INSPECTED BY
10/25/2018 1:03 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
AV
y [ 1 F >
G C �
� Imo, ,A
,• x rya-:� r�4���r � t: 4 it,� � �1.
y
. � 14
y y d
i
f y ig.4.
y
2 s
x 'f
f t
TOWN OF SOUTH.WINDSOR INSPECTION REPORT
PERMIT NO.: J CONTRACTOR: cl _
LOCATION: Lf Vf Ila I)PC/
TYPE OF WORK: foZ t 'Ma. P s'fv
DATE INSP NEEDED: DATE INSP: lile.111
INSPECTED BY;
WORK IN
PROGRESS: 46
SEPTIC TANK PUMPED,SMASHE®, FILLED 'WITNESSED ❑YES [] NO'
AS-BUILT: .
r
INPUT: `" DATE:
Vmdoy/fbi ms 2M4 Tb=of South Windsor YNPSO=N REPbgr 14
MD-Ws,Rev2/12 THE METROPOLITAN DISTRICT ^ PAVEMENT CUT DATE:
ADDRESS /�G, -S'! � mil' CliY 81LLJOB ❑ YES �1-NO WO#
CLOSEST STREET TOWN 7�� f �tr�y� STATE HIGHWAY ❑YES n<O-
DRAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND CUT MADE IN
CROSS SEC ON-OF PAVEMENT
F3EE7 I�TUM. d"
L ❑ CONC. ❑PREMIX
El SIDEWALK ❑BITUM. ❑CONC.-Il ❑FLAG
❑CURB O BITUM. 0 CONC. i El STONE
El DRIVEWAY ElBITUM. ❑CONC. /�
❑GRASS LOAM&SEED NEEDED ❑YES f�0
rr REASON FOR CUT: (-7 r�g--
DEPTH OF EXCAVATION: r '
NUMBER OF CUTS.-
DATE OF FIRST CUT:
I� IS JOB COMPLETED: QdrES ❑NO
FOREMAN: C�
REPLACEMENT PAVEMENT CONTRACT NO.:
r BITUMINOUS ❑ CONCRETE ❑ PREMIX ❑
_...:..._. DATE COMPLETED: Q
ACCOUNT NUMBER:
CALCULATIONS
l {` � e-?_/7 OF CUT ITEM# ITEM# ITEM# ITEM.#
PAVING INSPECTOR CONTRACTOR
(ORIGINAL) (YELLOM