HomeMy WebLinkAboutStreet Cut Permits 192 Graham Road (2) 1800183 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 12/18/2018
GIS ID: 37500192 FEE: 50.00
MUNIS APPLICATION# 201802456 EXPIRATION DATE: 12/18/2019
APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS: 192 GRAHAM ROAD
ADDRESS: 112 PROSPECT HILL ROAD OWNER: VOISINF ALLEN T
192 GRAHAM RD
EAST WINDSOR,CT 06688
PHONE
WORK DESCRIPTION: INSTALL NEW-GAS SERVICE W/O SE821920
WORKING ON HAVES ROAD SIRE
APPLICANT AGREES TO FURNISH THE-,TOWN OF SOUTH WINDSOR THE AMOUNT QF. BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWISI FORMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THEAPPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR,S TREE.T CUT PERMIT MANUAL.
ISSUED BY DATR-fNSPECTED INSPECTED BY
1/8/2019 2:19 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECITON REPORT
PERMIT NO.: ; 4119 CONTRACTOR: i LaA
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED.; DATE INSP: °'
INSPECTED BY: t>
WORK IN
PROGRESS:
Vell
SEPTIC TANK PUMPED, SMASHED, FILLED � WITNESS® ❑YES El NO-
AS-BUILT:
INPUT: (, DATE: �0-\CA
Sollil corms 2014 Tb m of Routh Wind'INP==REPORT 14
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APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
c TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $50.00
Name of Firm L V Phone No.
Address of Firm O eTILL Zip Code064Q
Location of proposed work
Describe fully nature of permit requested ?S rftL. Its �/4 S �E It,tl t CE
Starting date col— l F' Call Before You Dig No, ,�ISGD 340
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCHB IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut Pavement Cut ❑Curb Cut ❑Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed Nov Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic
Show sketch.of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est.Patch Sizes) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
^r Est Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est Traffic Control$
DRIVEWAYS must be aft or more from the property line per Amt.of Deposit$
section 2.17 of the zoning regulations
Total Due$
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES O Cash O Check#
Paid By
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REMRSE THE TOWN OF SOUTH WINDSOR FOR ANY
EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONVECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY
THE RULES W REGULATIONS FO PERMITS AS OUTLINED IN THE TOWN OF SOUTHH�WIINDSOR'S PtSTREET CUT PERMIT MANUAL
Signed: y Print NameLlJ004t Mbft$ A6 Date:/j
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Engineering/permits/Street Excavation Permit 2017
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The material contained on this map Title: / J ,? �rr� }�
shall be considered proprietary to
Eversource Energy and user (which is j1�r
defined as any person or entity CJ i.�h Information shown is not guaranteed and Eversource Energy
who has received the map through EVERS"URCE
ug
sale, purchase, exchange, gift, or
otherwise) shall keep it in confidence assumes no responsibility. Contractors are urged to call qW
and shall not furnish or disclose it Eversource Energy for further information at 1—800-989-0900 ENERGY
to any third party without the prior
written permission of Eversouce Energy. Plotted: 07—Dec-2018 By: gisewrl