HomeMy WebLinkAboutStreet Cut Permits 125 Edwin Road (2) 1800019 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 04/06/2018
GIS ID:29700125 FEE: 50.00
MUNIS APPLICATION# 201800429 EXPIRATION DATE:
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APPLICANT 1 x x,r` LOCATION
NAME: TELE—NETWORKS ADDRESS 125`EDWIN ROAD
ADDRESS: 31 BAKEWELL COURI x ; OWNER 125 EDVIN ROAD ASSOCIATES LLC
CRASTON,RI 0292 , �' ", 125DVVIN ROAD
SO�J'I'H WINDSOR,CT 06074
PHONE 401-461-8420 is
WORK DESCRIPTION: INSTAL
APPLICANT 3" ONDtJIT FOR CATV r„
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH W SOIZ THE AMOUNT OF B`.OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN C EXPENSES INCiJRRE6.-V.,THE TdWIti1 FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPI:I.CANT.1I4 FAMII IAR WITH AND WII L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SdL1TH WIN SOR'.S STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
4/6/2018 3:03 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT I
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PERMIT NO.: 90a j CONTRACTOR: /06 r!gL)r1�
LOCATION:_.• EA c�a.c�l •_—...
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TYPE OF WORK: s1" 1 1 0 }
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: '3
WORK IN
PROGRESS:__
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ N0
AS-BUILT: f
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INPUT: V DATE: ?J
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S/Molloy/forms 2014 Town of South Windsor INPSf5CMN REPORT 14
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APPLICATION FOR STREET EXCAVATION PERMIT
Appl, No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 060714 + FEE $60.00
Name of Firm �� i�Q'�l�i���� Phone No.� dl )�O�(JI
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Address of Firm M5 Zip Code 6Z.-I0
Location of proposed work l Z�� 1.0(W I''1
Describe fully nature of permit requested ►n Cj 0 C�`
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Starting date 5 I Call Before You Dig No„
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ZNo Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes CJ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
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0 Est. Patch Size(s) sf
Est. Pvt.Thickness in. f
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Est. Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ Jsf
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
O Cash O 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. l
Signed; +� Print Name - � Date: l
Enginee ng/per 'te/Street Excavation Permit 2017
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Node:SWA08 Planner:THOMAS DERWAY
Project Name:ANDRE CHARBONNEAU&SONS Planner Phone:
Project Address:125 EDWIN RD CIR#153068
ax City,State:SOUTH WINDSOR,CT Designer:TRUENET DG