HomeMy WebLinkAboutStreet Cut Permits 9999 Sycamore Road (7) 1900039 TOWN OF SOUTH WINDSOR, CT
PERMITNUMBER STREET CUT PUBLIC UTILITY
DATE: 05/03/2019
GIS ID: 88809999 FEE: 50.00
MUNIS APPLICATION# 201900827 ) XPIRATION DATE: 05/02/2020
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APPLICANT LOCATION
NAME: EVERSOURCE k ADDRi~S SPCA&ORE ROAD
ADDRESS: 112 PROSPECT HILL kbAp! :�et3 OWN>rR WTA WINDSOR TOWN OF
f7'S[LLIVAN AVE
7
EAST WINDSOR,GT 06088 y ks v
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WORK DESCRIPTION: EXCA.V�AtRi TO iNSTA)rI CAS 1vIAINAI�ID S VTOEr`
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APPLICANT AGREES TO FURNISH THi t'I O OF SOU I H WINDSOR THE AMOUNT OE BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIRY E3�PEIES INCURR�1?.IIY' HET0�47tI FOIE�VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIDE APPLICANT MT"; TAR WI H AID ?ILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN l7F SOiITI•I WINI�SOR':S ST1tEET CUT PETtMIT MANUAL.
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ISSUED BY DATE-INSPECTED INSPECTED BY
5/3/2019 10:31 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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'tGVYt OF SQ 'I{yyINDSORINSPEC 10. REPORT
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PERMIT NO.: a
LOCATION:
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TYPE OF WORK:
DATE INSP NEEDED.
DATE INSP: Sa " 71
INSPECTED W's .0•A
WORK:IN Z
PROGRESS:
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HED FILLED : 1NITNESSED ❑-YES CI NO
SEPTIC TANK PllMPEa,SNlA$ r
AS-BUILT: ,
DATE.
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S/moitcyffijms 2U4 Tmm of Sauth Windsor•If1PSECTtON IMPORT 14
Appl.rNo. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $50.00
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Name of Firma Phone No. _
Address of Firm DJR zip Code 069.0
Location of proposed work 6i
Describe fully nature of permit requested kf S 6AS A&4W WC
Starting date 'Wo Cali Before You Dig No,�O(j —f56 367�
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PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN-S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑No Pavement,Curb or Sidewalk Cut *avement Cut ❑Curb Cut ❑ Sidewalk Cut i
❑ Existing Driveway,No Changes ❑Proposed Driveway Widening ❑Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town l
two copies of separate drawing
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No.cuts
Est.Patch Size(s) sf
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Est. Pvt.Thickness in. l
�( Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
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Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price$ !sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
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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 ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR' T, IT PERMIT MANUAL. `
Signed: Print C_."64 A NiASeet Date:
Engineering/p rmi /Str t Excavation verrna w-t.