HomeMy WebLinkAboutStreet Cut Permits 9999 Clark Street (13) 1600154 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/11/20 I 6
GIS ID:20409999 FEE: 25.00
MUMS APPLICATION# 201601106 JoVL"`
'EXPIRATION DATE: 08/11/2017
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APPLICANT LOCATION
NAME: SIMSCROFT ECHO F1R1VI AD13SS kCAR STREET
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ADDRESS: P O BOX 581 fy n F C+WNEROUTI :WINDSOR TOWN OF
SIMSBURY,CT 06074 ; s I540rUI LIVAN AVE
UVINDSOR,CT 06074 _ _.... ..
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PHONE 860-65I-0231
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WORK DESCRIPTION: Cuo w I tQ H ENTRANCE CHAl'pNIS UI�gY�t ND CLARK STREET
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APPLICANT AGREES TO FURNISH TH TOW T QF OUTHk INpSCI TH1;11MOUI4 OFj BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FORA Y'I P) ISES INCLTRgED Y THE ITQW�F�J1t MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT A IAR WTTI1 t�N UVILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE ,EMIT MANUAL.
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ISSUED BY DA<-EITS.PECT" D INSPECTED BY
8/11/20161:08PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: 00 CONTRACTOR: 'S'I 0-�S'C_Y -t-"r
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP.
INSPECTED BY: 13v
WORK IN
PROGRESS:-
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: c DATE:
S/molloy/farms 2014 Town of South Windsor INPSEMON 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 $25.00
Name of -s 1 L . Phone No. (am) Ca61-coxJ 1
Address of Firm s td + L �'T Zip Code t�,ajc° 4U
Location of proposed work CL,,V<
Describe fully nature of permit requested C ,-
Starting date A,l q o�� . .ZOIL_o Call Before You Dig No lolly A3Zcac-"5 9Z
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATEJR THAN A YEAR.__..
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: Ei(Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est. Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
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 W DSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH
WINDSOR FOR ANY EXPENSES INCURRED BY TH TOWN 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 STR CUT PE MIT M U L.
Signe Print Name 4 , Date:_ t, `11�
Street Lavation Permit 14
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