HomeMy WebLinkAboutStreet Cut Permits 720 Governors highway (3) 1800101 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/23/2018
GIS ID: 36900720 FEE: 50.00
MUNIS APPLICATION# 201801280 EXPIRATION DATE:
APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS: ` 720 GOVERNORS HIGHWAY
ADDRESS: 112 PROSPECT HILL ROAD OWNER. BOTHA WAYNE
720 GOVERNORS HIGHWAY
EAST WINDSOR, CT 06?$8`
PHONE
WORK DESCRIPTION: INSTALL GAS SERVICE /OW82115
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY'EKPENSES INCURRED BYTHE TOWNEOR 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 S REST CUT PERMIT MANUAL.
/7 / C
ISSUED Y DATE INSPECTED INSPECTED BY
7/24/2018 9:13 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 0'6010 . CONTRACTOR: 'V KO 0 0 r`e
LOCATION: Ll-l � i A A
TYPE OF WORK: y
DATE INSP NEEDED: DATE INSP: 1 Z/ 7 t
INSPECTED BY: t3 0
WORK IN
PROGRESS: �vL'''k ! :t�`2 t A
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: C YV` - DATE:._/- 2 3 19 _
S/molloy/forms 2014 Town of South Wnr IWP WnON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $50.00
Name of Firm -F-n Phone No.gbp-- a-
Address of Firm 0 Zip Code
Location of proposed work D
Describe fully nature.of permit requested V 0_.1 as S2YV t
Cle-
Starting date Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN's CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ !ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
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
{ )Cash ( )Check#
Applicant is responsible for contacting the Police Dept. and C.B.Y.D
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 FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S ST T PERMIT MANUAL.
Signed: Print Name C Date: I g
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The material contained on this map Title: 960 10
shall be considered proprietary to
Eversource Energy and user (which is -f,1
sal ,defined as any person g r entity /t7l E"'VERSA.1111111111IF
who has received the map through Information shown is not guaranteed and Eversource Energy
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sale, purchase, exchange, gift, or 9 9Y
otherwise) shall keep it in confidence assumes no responsibility. Contractors are urged to call ENERGY
and shall not furnish or disclose it Eversource Energy for further information at 1—800-989-0900
to any third party without the prior
written permission of Eversouce Energy. Plotted: 17—Jul-2018 By: gisewrt