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HomeMy WebLinkAboutStreet Cut Permits 37 Sea Pave Road (4) 1400245 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER ' STREET CUT PERMIT DATE: 08/14/2014 N 5� GIS ID: 81700037 MUNIS APPLICATION# 20140 1 1 1 9 0 ' ' ,r FEE: 25.00 CPIRATION DATE: 08/14/2015 APPLICAN NAME: a s �� F r LOCATION MARTIN LAVIERO NTR ,CTOI h Sp��DRE�: 7rs�EAPAVE ROAD ADDRESS: 611 NORTH MAIN S1I ' �f�ECHIICAL MAINTENANCE CO P 0 BOX 1659 � AVE ROAD BRISTOL'CT 0601�4Q29 z i 41 ; 7 5 �} CF?ifiH INDSOR,CT 06074 PHONE 860-589-7579 fez: WORK DESCRIPTION: REJW,13 f r � APPLICANT AGREES TO FURNISH THEE O O OUT %iw RjND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FORA IfET•IES INC1IRRET�1 'TI TO�VF�1 kORIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND TIAPIaIIC, TIS F; IVIILAR,4If� � L ASIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN(3Fyot1TI WINDSpRg STR1E OiJ Tp� MIT MANUAL. vv ISSUED BY ATE INSPECTED INSPECTED BY 8/14/2014 9:59 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ^ " y _ c yy � 4P �� e Jay 4�y� � kw rt i Y gR L C' CIA TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 1 00, S- CONTRACTOR: �Y1, ' ► t1 y')end oi ��©r LOCATION TYPE OF WORK: cr-nil:%2. DATE INSP NEEDED: DATE INSP: f INSPECTED BY: WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: G � DATE: S/2814 Town of South Windsor INPSECriON REPORT 14 APPLICATION FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No, TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25,00 Name of Firm Martin Laviero Contractor, Inc. Phone No.860-589-7579 Address of Firm 611 North Main Street, Bristol CT Zip Code 06010 Location of proposed work37 Sea Pave Road South Windsor, CT Describe fully nature of permit requested EL di r 610 0-L a �0_ 0L (S fv 00l CJ L14 1216C C,✓.e,LQ Starting date 8/11/2014 Call Before You Dig No 20143202501 PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE, THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut ❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Wafer ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing No,cuts { tN 0 LZ) i eS 0 Est. Patch Slze(s)_ _sf Est. Pvt.Thickness in. Est. Patch Unit Price$ /sf Est.Patch Cost$ Est.Curb Replacement ft Est.Curb Unit Price$ A Est,Curb Cost$ Est. Sidewalk Replacement sf Est.Sidewalk Unit Price$ /sf Est.Sidewalk Cost$ Est.Traffic Hours hr Est. Traffic Unit Cost$ /hr Est.Traffic Control$ Amt. of Deposit$ Total Due$ ( )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'S STREET CUT PERMIT MANUAL. Signed: Print Name Date: Street Excavation Permit 2014 M V9.Rev2M2 THE METROPOLITAN DISTRICT- PAVEMENT OUT DATE:_ .S�®`/ k/ ADDRESS 37 BILL JOB ❑ YES ja"No VUO# CLOSEST STREET K 7 ' TOWN 4j`a''ClJOR, STATE HIGHWAY ❑YES ❑NO DRAW SKETCH SHOWIP G LOCATION AND SIZE OF CUTS AND CUT MADE IN CROSS ECTION OF PAVEMENT ©STREET ❑BITUM. ❑CONC. ❑PREMIX ❑SIDEWALK ❑BITUM. ❑CONC. 0 FLAG ❑CURB ❑BITUM. 0 CONC. I ❑STONE a P!rDRIVEWAY TUM.--J-' ❑CONC. ❑GRASS LOAM&SEED NEEDED ❑YES J ., x REASON FOR CUT; aG� . . in DEPTH OF EXCAVATION: , NUMBER OF CUTS: f i> Z j DATEbr FIRST CUT: '-3 / I I IS JOB`COlIIIPLETED: YES ONO FOREMAN: • ....... a R�PLAcr=MtNT PAVEMENT CONTRACT NO.: BITUMINOUS ❑ CONCRETE ❑ PREMIX ❑ DATE COMPLETED: ACCOUNT NUMBER: GALCUll;ATIONS : NO. � i OF GUT ITEM# ITEM# ITEM# ITEM# s l 'P 4t tt� 7?1 PRESS HARD, 3 COPIES P°'VI(ORIGINAL) CONTRACTOR R reC'd 7/18/2014 !I I M11039,Rev2n2 THE METROPOLITAN DISTRICT- PAVEMENT CUT DATE: .�"-3 o l r II ADDRESS see e - BILL JOB e IllYES K'O WO# -5'4 01,5- >j CLOSEST STREET R' ' TOWN `_°`���aRa STATE HIGHWAY D YES ONO DRAW SKETCH SHOWI G LOCATION AND SIZE OF CUTS AND CUT MADE IN CROSS S ECTION OF PAVEMENT O STREET ❑BITUM. ❑CONC. ❑PREMIX ❑SIDEWALK ❑BITUM. O CONC. " p FLAGTj " jD CURB O BITUM. ' CI CONC. I]STONE KDRIVEWAY ;?ErITUM.-J�b ❑ CONC. " OGRASS LOAM&SEED NEEDED ❑YES i m REASON FOR CUT: c� ca DEPTH OF EXCAVATION: o ro �: NUMBER OF CUTS: , i z Q. DATE'OF FIRST CUT: / f IS dOB`COMPLETED: ; YES ONO m REPLACEMENT PAVEMENT CONTRACT NO.: BITUMINOUS ❑ CONCRETE ❑ PREMIX ❑ ` DATE COMPLETED: I ACCOUNT NUMBER: `N CALCULATIONS : NO. $ i OF CUT ITEM# ITEM# ITEM# ITEM# m PAVING INSPECTOR CONTRACTOR PRESS HARD, 3 COPIES (ORIGINAL) (YELLOW) rec d 7/18/2014 �