HomeMy WebLinkAboutStreet Cut Permits 9999 Tudor Hill Road (3) 1900043 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
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DATVe: 05/03/2019
GIS ID:90309999 FEE: 50.00
MUNIS APPLICATION# 201900832 `EXPIRATION DATE: 05/02/2020
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APPLICANT LOCATION
NAME: EVERSOURCE # N ADDREs 9999AJDOR HILL ROAD
ADDRESS: 112 PROSPECT HIL;ROAp OWNF,R t$OrUTI ,WINDSOR TOWN OF
FX , 140 SULLIVAN AVE
EAST WINDSOR,O','17.0608.8 1
PHONE L
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WORK DESCRIPTION: EXAUA TTb 11VTALL GAS Iv1.41N ANC SEIVICE,A
APPLICANT AGREES TO FURNISH THEtiTOVVN OF SOUTI WIND$QR 1TE AMOL11V1 O BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A :EXPial*1SES IIrrIJKRED;I3X TIE TOWN FORMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AI''I ICANT IS FAMMIAR WJT AZxiD 11 L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN` ,5A11TI3 W'1iDS(3R':S STIT. iJT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
5/3/2019 2:33 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TaW OF SQUTNV114DS�R INS*C'to REPART
PERMIT NO.:
60
CONTRACTOR:
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TYPE OF WQRK:
DATE DISP NEEDED: DATE INSP:. r� 17 l
INSPECTED BY: -
WORK.IN
PROGRESS: ail •
SHED FILLED WIMESSED ❑YES [� NO,
SEPTIC TANK PUMPEDr SMA. : r
INPUT: -
DATE: d s
S�incS(oyjforms 700 Town of South Windsor MPSWON REPORT14
t,a a L.raVr\a IVa• ■ Va\ %0 a a verer a IV! .. •Y.. a.r•�aau .
Appl..No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $50.00
Name of Firm
{�} u GLo Phone No. r a a tot
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Address of Firm 0 4 Zip Code
Location of proposed work 6QZD
Describe fully nature of permit requested CL3 AAAW 4 S C
Starting date Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut 'avement Cut ❑Curb Cut ❑Sidewalk Cut
Cl Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: 11 Public Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
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Est.Patch Unit Price$ Isf
5� P I CO 5 Est. Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price$ Isf
Est.Sidewalk Cost
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
I
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 J013SITE 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 ST1T PERMIT MANUAL. I
Signed: t Print Name &U( A - I V/,`Se✓1 Date: J� r
Engineering/p rmi /Straet EXCaVatiOn rarrniL w.L f