HomeMy WebLinkAboutStreet Cut Permits 291 Avery Street (4) 1900117 TOWN OF SOUTH WINDSOR, CT
PE ��IT NUMBER STREET CUT PERMIT
DATE: 07/25/2019
GIS ID: 06300291
MUNIS APPLICATION# 201901548 FEE: 50.00
XRIRATION DATE: 07/24/2020
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APPLICANT
LOCATION
NAME: AIROLDI'S INC. s0 ESS 291 AVER STREET
ADDRESS: P O BOX 71 fi l
} OWNER I�ALF"N HIRLEY ANN&JAMES J
SOUTH WINDSOR CT 0607 G t s
PHONE
WORK DESCRIPTION:
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APPLICANT AGREES TO FURNISH THE TO V4 IV Or-SOUTH WINDSOR TII) AIk�{�UN;PpF$pI D R QUIRED AND TO REIM$URSE
THE TOWN OF SOUTH WINDSbR FOR ANY]XP I�[SEs INCURRED$Y TFI1r TOW1V F. MIA, ENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APP .XANT IS FAMILrIAR WITH AND WILIBDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF $SIZE
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INSPECTED BY
7/25/2019 1:26 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TaflVl �F SQUTN 11VINDSQR I1li5PEC1lOx REPORT
PERMIT NQ.: l. ., CQNrAAM+
LOCATION: 91
TYPE OF WORK:
DATE+INSP NEEPEDff _ .. : DAN INSP:.
INSPECTEQ'
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PROGRESS:
SEPTIC TANK PUMPEiD,.SMASHED; FILLED WrMESSED ❑YES CI NO-
AS-BUILT:
INPUT: DATE.
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5/m6NoyAtms 2014 Town of South Windsor•INP5iLtMbN REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appi. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $50.00
Name of Firm Phone No.
Address of Firm ca Zip Code
Location of proposed work �-
Describe fully nature of permit requestedStarting date- W-LIN Call Before You Dig No A 0
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: 11
1NNo Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑Curb Cut ❑Sidewalk Cut
® Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch.of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
—� Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
DRIVEWAYS must be 3ft or more from the property line per Amt.of Deposit$
section 2.17 of the zoning regulations
Total Due$
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES ( )Cash ( )Check#
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 WII,N,DnSOR'S STREET CUT PERMIT MANUAL.
Signed: Print Name r 't 'L �`t`Q ! � �"l r Date:
Engineering/permits/Street cavation Pe it 2017
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