HomeMy WebLinkAboutStreet Cut Permits 38 Stedman Circle (2) 1900138 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/13/2019.
GIS ID: 85300038 SEE: 0.00
MUNIS APPLICATION# 201901747 u; EsXPIRATION DATE: 08/12/2020
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APPLICANgl� `"P' h z LOCATION
NAME: AIROLDI'S INC. ¢ ADDRE8 STE MAN CIRCLE
ADDRESS: P O BOX 71
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3 STEIWAN CIRCLE
SOUTH WINDSOR, + €T p6,7 `,
PHONE
WORK DESCRIPTION: DRI /gW
AYF CO�LI✓GTED ON#LPL 20I (1��0IIICH WAS ENTERED
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APPLICANT AGREES TO FURNISH THEE OWI QF'SQI. U1H�ITIDSQR$'1'HIr�AMOU T�OR> fND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A Y lXP,tXsu-S INCi7RdIED BY T,�I�TQt�15F`�ORA INTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TFI) A3'P�IAAiT 15 FAIl+II11R W TI AND 17VLaL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN( SJT WINDSQR'StSTRE1;T QUTPERMIT MANUAL.
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ISSUED BY DATE'I1gsPECTED INSPECTED BY
8/13/2019 12:43 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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PERMIT ND.; 9 oo/ CON' RACT)R.
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TYPE OF WORLLIY
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DAA INSP NEEDED: DATE INSP:. -
INSPECTED BY:
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5/moliay/f n.m ZK4 Town of South Windsor•MNS& ON REPORT 14
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APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No, TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR, CT 06074
FEE $2.6-.W
Name of Firm {' Phone No. (j
Address of Firm Zip Code C" u _
Location of proposed work
Describe fully nature of permit requested .
Starting date Z Approx.time for completion 1azz
Call Before You Dig No. Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish, This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
0
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
p Est. Patch Unit Price$ /$I
Est.Patch Cost$
Est.Curb Replacement ft Est.Curb Unit Price$ /ft
1 --47 Est.Curb Cost$
Est.Traffic Unit Cost$ /hr
IL Est.Traffic Control$
Amt.of Deposit$
Total Due$
3< ( )Cash ( )Check#
Applicant is responsible for contacting ` Paid By
the Police Dept.and C.B.Y.D.
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 OU LINE IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
Title: Driver's License#: o1"-��' :'
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-06