HomeMy WebLinkAboutStreet Cut Permits 48 Patria Road (2) 1800054 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 05/24/2018
GIS ID: 69900048 FEE: 50.00
MUNIS APPLICATION# 201800755 EXPIRATION DATE:
APPLICANT > LOCATION
NAME: CONNECTICUT WATER COMPANY' ADDRESS 48 PATRIA ROAD
ADDRESS: 25 NORTH ROAD YS t OWNED FORTXEIGHT PATRIA ROAD ASSOCIATES
EAST WINDSOR, CT�y6�08s r 48 PAT1fIA ROAD
jdUTH,WINDSOR,CT 06074
PHONE 860-623-3355
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WORK DESCRIPTION: WORK1 fiG AT EIaiD OF ROAD:TO RE iJACE I1 E T YE RANT
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APPLICANT AGREES TO FURNISH THITOWI*T OF SOUT'1I WI�IDSR THE AMOUNT QP BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXF2;1�[$E$1NGU�REI3 BY THia TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE A m-xa WITH 1 D WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S(?UTH WTIVDSOR'S RTREET CU PERMIT MAN]JAL.
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ISSUED DATE INSPECTED INSPECTED BY
5/24/2018 12:33 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ? DUd .L CONTRACTOR: LA C—
LOCATION:
TYPE OF WORK:-Q,to,21 h-f- r a 1-� Coro jD
DATE INSP NEEDED: DATE INSP;
INSPECTED BY: `�
WORK IN
PROGRESS:
.SEPTIC TANK PUMPED, SMASHED, FILLED WTfNESSED ❑ YES [] NO
AS-BUILT:
INPUT:
S/molloy/forms 2014 Town of South wiridsor INPSECTION 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 $25.06—
Name of Firm CT Water Company Phone No. 860-622-9592
Address of Firm- P.O. Box 857 East Windsor (25 North Rd) Zip Code
Location of proposed work_ Patric Rd q X
Describe fully nature of permit requested_Working @ the end of the road to replace fire hydrant. _
Starting date 5/24/2018 Call Before You Dig No 20182101165
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: Cl No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est, Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
s Est.Sidewalk Replacement sf
Est. Sidewalk Unit Price$ /sf
Est.Sidewalk Cast$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )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 STREET CUT PERMIT MANUAL.
Signed:__- / _ Print Name C i �t� �' •-� Date:
Street Excavation Permit 2014
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