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HomeMy WebLinkAboutStreet Cut Permits 71 Wentworth Drive (3) 1800021 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 04/1 2 1 3/ 0 8 GIS ID: 93300071 FEE: 50.00 MUNIS APPLICATION# 201800455 EXPIRATION DATE: 44, APPLICANT LOCATION NAME: TELE-NETWORKS LS ADDRESS 71 VVINTWORTH DRIVE ADDRESS: 31 BAKEWELL COURT OWNER RUSSELL DOUGLAS K& SARA J CRASTON,RI 02921, WEN TWORTH DRIVE S4UniWINDSOR,CT 06074 PHONE 401-461-8420 r # WORK DESCRIPTION: INS�`FAI,L ING REPLACING CATV V APPLICANT AGREES TO FURNISH THOTOWN OF SOUTH WIND3+DR THE,AMOIINT QF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANC LXPEIVSES INCURRI✓DBY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE APPLICANT I5 FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN C)F SOi1TH WINDSOR.' STREET CUT P:EiMIT MANUAL. 'YV10l 10 _ � ISSUED BY DAT °SPECTED INSPECTED BY 4/13/201810:55AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** i i h n. "h r Al 4 mvm +t ly r T � t 1, t r i ji Ge fh r 4 1 1 ,y 1 Nary 3 Al yw is l i { TOWN OF SOUTH WINDSOR INSPECRON REPORT PERMIT NO.: OL 0a I CONTRACTOR: "r�e �e- M cTw o(t S LOCATION: j,)�e(aT w L TYPE OF WORK: l 1 � ;�T��;r cATV .. DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: , I� - �� ' l�it� - . V SEPTIC TANK PUMPED,SMASHED, FILLED wrmESSED ❑YES ❑NO AS-BUILT: INPUT: DATE: S/mogoy/fom w 2014 Town of SoA Windsor INPSEtMN PEPbRT 14 i i APPLICATION FOR STREET EXCAVATION PERMIT , Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. ff TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $50.00 Name of Firm t� - �l}J U�r � Phone No. �Eo 1 3 Address of Firm [ S ct c S 6 J t LL Z� Zip Code 0 U Location of proposed work Describe fully nature of permit requested 1'n S _�_ } Cy t'P�`lriG l�1 C, (,A'{ Starting date Call Before You Dig NoQ( PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE, THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,ENCLUDING ANY INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: CdNo Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑Sidewalk Cut ❑ Existing Driveway, No Changes © Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Water ❑Well Sewage Service: I] Public Sewer ❑ Septic Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing / 0 No.Cuts Est. Patch Size(s) sf Est. Pvt.Thickness in. Est.Patch Unit Price$ !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 i 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 ( )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 ASIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S TREET CUT PERMIT MANUAL. Signed: Print Name Date: Engineer! g/per is/Street Excavation Permit 2017 Replace 200 ft. of UG feeder cable from output of yRd ' the 11/2 tap at Hse#71 Wentworh Dr. to input of 9 LE-SWc5131 at Hse#95 Wentworh Dr. Tech ' A,I'll Supv. Al Gesomino 860-250-34741 ------- Replace 200r UG Feeder CLI Leak under Driveway. Node SWC51 --------- ESR000002595272 / • ,/ ,/ RI � 2i9 7 / . R2 /'y92 SWC5108 SWC5131 , All cpu / ,y R.^ b NO / M3 / 112 ; 4 / II3 R2 tab R2 �f $ / g/ I a I 129 19 / ,29 k' / �" P1 / RI 4N \ R2 / O �Ol \ �S Awl A126, Notes: �18ic�t7 15�2 wF Date Created:0112412018 16:27:48