HomeMy WebLinkAboutStreet Cut Permits 240 Chapel Road (2) 1700236 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 12/05/2017
GIS ID: 18000240 FEE: 0.00
MUNIS APPLICATION# 201701735 EXPIRATION DATE: 12/05/2018
APPLICANT LOCATION
NAME: VMS CONSTRUCTION.COMPANY ADDRESS: 240`CHAPEL ROAD
ADDRESS: 162 LAKE STREET, OWNER: DABROWSKI HIPOLIT C&BOZENA
VERNON ROCKVILLE,CT 06066 56 FARM BROOK LANE
SOUTH WINDSOR,CT 06074
PHONE 860-871-0278
WORK DESCRIPTION: EXCAVATE TO OPEN UP MANHOLE TO ALLOW FOR LINING WORK TO BE
PERFORMED NO`FEE TOWN PROJECT
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 WIM'S STREET CUT PERMIT MANUAL.
mo N -
ISSUED DATE INSPECTED INSPECTED BY
12/5/2017 11:46 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:—flet9d CONTRACTOR:
LOCATION: `l 0 C o
TYPE OF WORK: Eyzaon 4e fz�rye a iT a kn IP Ac r o ;,74 I, oer,�C
DATE INSP NEEDED: DATE INSP: z &
INSPECTED BY: f5 1)
WORK IN
PROGRESS: G°-n) 1��ee/a c:r to
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: '. DATE:
S/molloy/forms 2014 Town of South Windsor INPSECrION REPORT 14
a 00 ® ` 7J s APPLICATION FOR STREET EXCAVATION PERMIT 1100 ad 36
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $60.00
Name of Firm_ VMS Construction Company Phone No. 860-871-0278
Address of Firm 162 Lake Street Vernon, CT Zip Code 06066
Location of proposed work 240 Chapel Road
Describe fully nature.of permit requested Excavate to Open up Manhole to allow for lining work to be performed
Starting date 12/11/17 Call Before You Dig No 20174701358
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut El Pavement Cut ❑ Curb Cut ❑Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ® Public Sewer ❑ Septic
Show sketch of proposed work or fumish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Per Chapel Road Project Plans and Specifications Est. Patch Size(s) sf
0 Est. Pvt.Thickness in.
Q ��e �Q� � ��,��� � Est.Patch Unit Price$ /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$ Ihr
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.B.Y.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 FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S PERMIT
Signed--�` Print Name Brett Adams Date: 11/30/17
Engineering/permits/Street Excavation Permit 2017