HomeMy WebLinkAboutStreet Cut Permits 71 Cadbury (2) 1700167 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PUBLIC UTILITY
DATE: 08/16/2017
GIS ID: 15900071
MUNIS APPLICATION# 201701092 FEE: 0.00
EXPIRATION DATE:
APPLICANT LOCATION
NAME: EVERSOURCE
ADDRESS: 112 PROSPECT HILL ROAD ADDRESS: 71 CADBURY
EAST WINDSOR, CT 0608$ OWNER: LACHANCE YVES J&ROSALIE A
71 CADBURY LANE
PHONE SOUTH WINDSOR, CT 06074
WORK DESCRIPTION: GAS SERVICE EXCAVACTION TO REPAIR GAS SERVICE LINE
APPLICANT AGREES TO FURNISH 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 THE APPLICANT IS 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.
ISSUED BY J7DATE INSPECTED
INSPECTED BY
8/16/2017 12:23 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1-��..7 CONTRACTOR: ' kJfA
LOCATION: 7
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: L a at 1 i 3
INSPECTED BY: [�
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED
❑ YES ❑ NO
AS-BUILT:
INPUT: �
DATE:
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 SU®LLiVAITAVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm V` h Phone No.
Address of Firm #
:
Location of proposed work Zip Code
Describe ttjlly n #ure of permit requis
Starting date Call Before You Dig Nct
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA;CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT'COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes p Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply:, U Public Water U Well Sewage Service: El Public Sewer ❑ Septic
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North Th1s s [oit tt1 be ffllod out bar'tcawn
No.cuts
O Est. Patch Sizes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est Patch Cost
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft;
Est.Curb Cost
Est.Sidewalk Replacement_ sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost
Est,Traffic Hours }1r
Est.Traffic Unit Cost$ /hr
Est.Traffic Control
Amt.of Deposit$
DRIVEWAYS must be 3ft or more from the property line per Total Due$section 2.17 of the zoning regulations
Applicant is responsible for contacting the Police Dept.and C.BY.D (- )Cash; ( )Check#
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 FAMI R WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S CUT PERMIT MANUAL.
Signed,"
Print Nam Date, `
Street Permit 2014
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The material contained an this moo .
'hill be ronsidered preprietory , Title:
Eversousce Hnergy.,.d set(Which is
d.fiW"h.d as any person a entity
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Who has'eseived the ma throw h � ,
sale p rchcs exchange rrft or �nE.armof�an shown is mat guaranfeec anc=verso rce Energy
o.herwise)shall keea t i confidence assumes ^.o respo-.s 6ii:ty. gcxtfrae treS ore urged to„oft [T
and shell not furnish or disclose t Evsrsource Energy for furthe�inforcm tnn at t-8J0—yfig—gyp(} ENERGY
as ony third party withcut ^e on- G 4
-mien permission of E-rsouce Energy. Plate i.26-0-201: I 2y cii—rl