HomeMy WebLinkAboutStreet Cut Permits 443 Rye Street (2) 1800139 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 09/19/2018
GIS ID: 78600443
FEE: 50.00
MUNIS APPLICATION# 201801724 EXPIRATION DATE:
APPLICANTY # LOCATION
NAME: EVERSOURCE 7 9 ADDRESS' 44Y STREET
ADDRESS: 112 PROSPECT HILI,R j2 ADS Tz,4' str z' '„ Y ONERCGR�I H DAMES B&DORAN ANNE M&
sH ISIN STREET
EAST WINDSOR, 6(8$ s �
PHONE1
WORK DESCRIPTION: INS s GASEVtE
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APPLICANT AGREES TO FURNISH THEOW1 O S'pUi iltwwII1�SRFIE AMQUIIT ?F,BND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN�)NS�EStD,jURREI:Li 1' $TQWNsORI4INTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S(�1)'T�I W1NDS0 STR1rT GU7*PF111�IIT MANUAL.
ISSUED BY J SPECTED BY
9/19/2018 1.45 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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MWJR OFSOUTH•.WINDSOR INSP'EMN REPORT.
PERMIT NO.: D CONTRACTOR: e.
LOCATION:
TYPE OF WORK:
DATE IN P`NEEDED: DATE INSP: 62-1.20 I/
INSPECTED BY: -6-D .
WORK IN
PROGRESS: Jk �5 r,�
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES C] NO-
AS-BUILT:
INPUT: ~ DATE:
Slmoifoy/f =M14 Town of South Windsor.3NPSknbN REpbgr 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 $50.00
Name of Firm f�n Phone No. t �r
Address of Firm D I Zip Cade 00
Location of proposed work
Describe fully nature_of permit requested v 1
Starting date oat 1i Call Before You Dig No O 11
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT;INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR,
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑Proposed New Driveway
Water Supply: ❑Public Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price
Est.Patch Cost$
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
OCash ( }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 :�Fo tz O y�
Date: Ct (D 19
Engineering/p rmi /Stre t Excavation Permit 2017
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The material contained on this map Title: q f-4c 17,
shall be considered proprietary to
Eversource Energy and user (which is "j1� 14
defined as any person or entity tv1
who has received the map through Energy orma EVERSAO"UORCE
Information shown is not guaranteed and Eversource Ener
sale, purchase, exchange, gift, or
otherwise) shall keep it in confidence assumes no responsibility. Contractors are urged to call
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: 06—Sep-2018 By: gisewrl