Loading...
HomeMy WebLinkAboutStreet Cut Permits 20 Oak Street 1600180 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 09/20/2016 GIS ID: 65400020 ' : MUNIS APPLICATION# 20-1601322 - FEE: 25.00 y XPIRATION DATE:RD 09/20/2017 APPLICANT NAME: v LOCATION QUALITY PAVING Ij f A117R5S ` 20 DAIS STREET ADDRESS: 194 S. MAIN STREE'fi f `' OWNER '' 1YAN VIIV J& EAST WINDSOR,C'06(88 T ,,w j 20 QtYKT PHONE 860-5234182 f = S JUTH WINDSOR,CT 06074 y 1 F. t5 •y't 7 P WORK DESCRIPTION: DRD i10t ' Y APPLICANT AGREES TO FURNISH TH ti �'� LSa i„ �� r i• 'OWN QF SO UTIWIIS`pR THE AMQUNTF BjND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR Ala1Y XpE1 SEg I jC`Ul Zj g yr jj�TO F R MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND Tit APpI, ArIT IS FA +1T) IT ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OE SO!TH WINDSO 'STREE Ci? 'ERIVIIT MANUAL. ISSUED BY DAT]i-I SP-E TED INSPECTED BY 9/20/2016 9:05 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** -------------- ,0 Z 7xf3��r ri r J,f 5 q y 4 a� 1:`' 3 �� 1 G t S. 2 ..t• � ..� 24z i xrY 1r y r 4- ,': 9 p.}•F ">,' h' S ka =0'4 erg ' wYt TOWN OF SOUTH WINDSOR INSPECTION REPORT OV PERMIF�V©.._ ''" NTRAETAI�- LOCATION: /� S TYPE OF WORK: �)( Ve L DATE INSP NEEDED: DATE INSP: 1 INSPECTED BY.- 1 WORK IN PROGRESS: be . SEPTIC TANK PUMPED,SMASH9D,FILLED WITNESSED ❑YES ❑ NO AS-BUILT:. S[moBay/forms 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 $25.00 Name of Firm . L12Z� trr t " �' Phone No. S� Address of Firm CC Soz� C '— LG� Zip Code G 0 cS Location of proposed work C) ' Describe fully nature of permit requested Starting date Z QAZ Call Before You Dig No PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut CO Existing Driveway, No Changes Proposed Driveway Widening ElProposed New Driveway Water Supply: ❑ Public Water " ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing No. cuts Est. Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price ,/r 1 I 2� �eN�) Est. Patch Cost$ Est. Curb Replacement ft G Est. Curb Unit Price$ /ft Est.Curb Cost$ 11 yv I Est. Sidewalk Replacement sf c± Est. Sidewalk Unit Price �D I A Est. Sidewalk Cost$ I ,✓b� � ` Est.Traffic Hours hr P Est.Traffic Unit Cost$ /hr Est.Traffic Control$ 1 Amt.of Deposit$ Total Due$ l p ( )Cash ( )Check# Applicant is responsible for con acting the Police tjept.and C.B.Y.D PERMIT SHALL BE KEPI'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 NameY C� � ( , Date: Street Excavation Permit 2014