HomeMy WebLinkAboutStreet Cut Permits 195 Kent Lane (3) 1600163 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 08/23/20I 6
GIS ID:50100195 :t
MUNIS APPLICATION# 201601159 y{ FEE: 25.00
x EXPIRATION DATE: 08/23/2017
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APPLICANT"
LOCATION
NAME: GENERAL PAVING ND CONSTIrUCTIdN ADDR��S �IgS` T LANE s
ADDRESS: I218 CROMWELI AVE1*UE S�WNER GIGLIQROBERT L&CAROL L
ROCKY HILL,, CT 060�67. ;� =�ti 195I�rEI�T LA
PHONE " $QIfITI UVINDSOR, CT 06074
WORK DESCRIPTION: �i , s� i
DRI �WAY
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APPLICANT AGREES TO FURNISH THE TOW 11�F`SOUTH WII�I�'s . IE AMc UN � g ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANYPNSI~�II`fURRED BY THE TOUN F 1IAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TEE APPLICANT IS FAi1ILIA1t WITH ANI WII;I(ABIDE BY THE RULES AND REGULATIONS
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NI}SOR' STREET GUT�p1,RIbIIT ym �. TEDBYF E-llS=PELTED
INSPECTED BY
8/23/201611717AM **+ PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO CONTRACTOR:_ ��
LOCATION: I �� /<<°Y74
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: IL LIZ
INSPECTED W.
WORK IN
PROGRESS:
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
S/molloy/forms 2014 Tom of South Windsor INPSEM01TREPOU 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 $25.00
Name of Firm A Phone No.
Address of Firm i C� c, 1 T Zip Code c)60(,``7
Location of proposed work �c
Describe fully nature of permit requested e_ �,r�
Starting date Call Before You Dig No ozp/ r a2
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Frl'-xisting Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
0Est. Patch Size(s) sf
"t Est. Pvt.Thickness in.
Est. Patch Unit Price
Est. Patch Cost$
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$ 1hr
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: r' Print Name f a Date: 0-1j'77h ('
Street Excava ion Permit 2014
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4218 Cromwel�Av ,• Ros ky Gbnnectrc± p ►6`7'
Felbpfione 860-2.57 i;i37, -
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PHOPOSAL SUBMiFrED TO _. : DAM
NAME -� 1 JOB NAME
SEFr Sketch of Work Area:
PHONE :
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Work to be performed:
1. Fine grade existing base material,add process
stone for finegrading as needed and pave w/3"of
asphalt.
2_ Remove
existing asphalt,add processed aggregate for
fine grading as needed and pave w/3"of asphalt. '
Excavate existing driveway,install 0 of processed
aggregate and pave w/3"of asphalt.� � �
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Type of work to be performed will be circled above. `
Back filling curb or edges of pavement is not included in
our price and shall be completed by others_Not responsible
for Damage to Concrete Sidewalks.
Start Date:within 45 days from transaction date �r
Completion Date:within 45 days from start date