HomeMy WebLinkAboutStreet Cut Permits 100 High Street (2) 1800035 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/17/2018
GIS ID: 42000100 FEE: 50.00
MUNIS APPLICATION# 201800484 EXPIRATION DATE: 04/17/2019
APPLICANT LOCATION
NAME: AIROLDI'S INC. ADDRESS: 100`HIGH STREET
ADDRESS: P O BOX 71 OWNER: CONACI ANTHONY& SHARON
SOUTH WINDSOR,CT 06074 100 HIGH STREET
SOUTH WINDSOR,CT 06074
PHONE
WORK DESCRIPTION: DRIVEWAY REPLACEMENT
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 OUTLI/N�ED/IN THE TOWN OF SOUTH WIN SOR' STREET CUT PERMIT MANUAL.
/! G1 0
ISSUED BY dATE INSPECTED INSPECTED BY
4/17/2018 9:49 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 12 0 0c 3 CONTRACTOR: I J
LOCATION: 11`, 0� c4Ia S gy T
TYPE OF WORK: Zk � a
DATE INSP NEEDED: DATE INSP: 1 .tits
INSPECTED BY: l
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: G DATE:
5/moiloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
A-ppl• No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT t�
1640 SULLIVAN AVENUE Date: -
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm � Phone No. _fig
Address of Firm • 0, ox (--IS� l,t> u,` Zip Code
Location of proposed work /[�•o Y,' k -T
Describe fully nature of permit requested j * �
Starting date J-) 7 l8 Approx.time for completion
Call Before You Dig No. g i��Dv S 5 Existing Water Supply: ❑Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est. Patch Size(s) sf
Est.Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est.Patch Cost$
�' Est.Curb Replacement it
i
Est.Curb Unit Price$ /it
Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
Cj
Est.Traffic Control$
V
Amt.of Deposit$
;gal l
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.D.
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
PERMIT7AS LIT I EDIN T E TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: " Date:
Title: N i.3 (� 1 �r h I s b S S y qAl Driver's License
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08