HomeMy WebLinkAboutStreet Cut Permits 9999 Clark Street (11) 1600155 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/11/2016 ".
GIS ID:20409999 FEE: 25.00
MUNIS APPLICATION# 201601107 if r XPIRATION DATE: 08/11/2017
e 55 k h
APPLICANT f M LOCATION
�KhNAME: SIMSCROFT ECHO FARMS AI7) RESSART STREET
ADDRESS: P O BOX 581 . fJWNER> -,OUTl WINDSOR TOWN OF
SIMSBURY,CT 06Q Qy"; 154ff' ULLIVAN AVE
4 t S�iTTH WINDSOR,CT 06074
PHONE 860-651-0231
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WORK DESCRIPTION: STI E��x��CA�ATI�3I+I FOR�ANI3`ATLtY�� �TIE INN
13
APPLICANT AGREES TO FURNISH THAPFOWN I(6FI: ITII WI IDSQIZ.�', ° OUIENTSOF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY PENISES IN iI RE9.BY VIE T}V Fb1 MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND I E PLIt; NT IS PAMII TAR Md t A UJI1'_L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SQUTI WINDSO 'S 4TR11;T C,UTT'$RIVIIT MANUAL.
ISSUED BY DATEPECTED INSPECTED BY
8/11/2016 1:11 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l OeD/tom CONTRACTOR: c rd
LOCATION: C\ a,C� S �
TYPE OF WORK: C WP 1 IV --—
DATE INSP NEEDED: DATE INSP: :'
INSPECTED BY: c,;,)�
WORK IN
PROGRESS: u %r�r ;i r �� /%,
7 ... tiL iP„C'i '•°'*�b.(��i-c3� � r'�1 1'YYi h c /'V'�..A:u _
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT:. �. �'� DATE: I^ CH U
S/motfoy/forms 2014 Town of South Windsor INPSECRON REPORY 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 $25.00
Name of Firm rnnic-m—U- t sx,-s. _Ln Phone No. t 9�Lp4 Lo-!1-Oz,31
Address of Firm Z V.LL�zD�� t '",'. �.� � c�7� Zip Code o'40
Location of proposed work �-
Describe fully nature of permit requested
i c,_-
Startingdate .i,-sl-. zolu _ Call Before You Dig No ' o
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.a __....
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: Sil/Public Water ❑ Well Sewage Service: ❑ Public Sewer Cl Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
'y Est. Patch Unit Price$ Isf
I Le Est.Patch Cost$
.. Est.Curb Replacement ft
S/r,H Est.Curb Unit Price$ /ft
it
Est.Curb Cost$
i
Est.Sidewalk Replacement sf
y Est.Sidewalk Unit Price
w Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
i
Amt.of Deposit$
t
DRIVEWAYS must be 3ft or more from;he 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 TH OWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT I AM FAMILIAR WITH AND WILL ABIDE BY HE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S STREET T PER IT MANUAL. -~ J {
Signe • Print Name!M '"lu-.- 0C_f_ ti Date:
Stre t Excavation Permit Y r `