HomeMy WebLinkAboutStreet Cut Permits 7 Woodhaven Circle (3) 1600070 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/24/2016 y
GIS ID:96600007 FEE: 25.00
MUNIS APPLICATION# 201600655 n
IXPIRATION DATE: 05/24/2017
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APPLICANT LOCATION
NAME: CENTRAL SEALINQ CO INC ADDRESS �7 WOQDHAVEN CIRCLE
ADDRESS: 150 SUNSET RIDGE�tDRTITE OWNERERRId?AUL E&BETH R
EAST HARTFORD,CT 0,6 08 7d*00b�HAVEN CIRCLE
is 7 f SOUTH WINDSOR,CT 06074
PHONE
WORK DESCRIPTION:
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APPLICANT AGREES TO FURNISH OV�V QF'�O�TFHt.�tNDSOk�TI,jE`AIV-0W4T OF 1.OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A±IT� �{PNSES INCT�IRED ' THE TOWN MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T E APPL>CANT;IS m."." IAR'w"M { I�V4� L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINEV IN THE TO TRI ET GUT.PEMIT MANUAL.
ISSUED 8t DATE 0< PP" TED INSPECTED BY
5/24/2016 9:31 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1609 70, CONTRACTOR:C,a/�� r j�L—
LOCATION:_ C/ Af --
TYPE OF WORK: t L'O e
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: �
WORK IN
PROGRESS: ;jr; ?.,
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: ; C�
S/molloy/Forms 2014 Town of South Windsor INPSEMON REPORT 14
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APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN BALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name of Firm 0'em�y&" Sea- I 00 1 n Phone No. Ree) "
Address of Firm f 1�b S H-Ce r ' yz�, C" Zip Code
Location of proposed work V�C'-t, -- .-
Describe fully nature of permit requested he- V ,Ne et—iV� (LC146e
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Starting date 1(o Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE, THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. I
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Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk ECut
Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New'•;Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ ISeptic
Show sketch of proposed work or furnish two copies of separate drawing Indicate North This section to be�fill®d out by Town
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No.cuts
Est.Patch Size(s) Sf
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Est.Pvt.Thickness 1 in.
Est.Patch Unit Price!$ /sf
Est.Patch Cost$
f
Est.Curb Replacement ft
Est.Curb Unit Puce /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price---------------------
Est.Sidewalk Cost$
Est.Traffic Hours 1 hr
Est.Traffic Unit Cost$ Ihr
Est.Traffic Control
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�4 Amt.of Deposit$ 1
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Total Due$ �
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Applicant is responsible for contacting the Police Dept.and C.B.Y.D )Cash Checl�#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
1
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 WrrH THIS PERMIT AND
THAT 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S STREET CUT PE I��TII MANUAL 1 r
Signed: PWit
�'U�� Print Name u 11 7er I Z � Date:
Street Excavation014