HomeMy WebLinkAboutStreet Cut Permits 85 South Satellite Ro (8) 1700006 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 01/24/2017
GIS ID: 84000085 3 FEE: 25.00
MUNIS APPLICATION# 201700062 t EXPIRATION DATE: 01/24/2018
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APPLICANT 4` LOCATION
NAME: TELE-NETWORKS ti ADORES ' ' �8sOXTTH SATELLITE ROAD
ADDRESS: 31 BAKEWELL COC-RT'�f �3WNER S SOIJ H SATELLITE ROAD LLC
CRASTON,RI 029212 �80 STELLITE RD
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SOUTH WINDSOR,CT 06074
PHONE 401-461-8420
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WORK DESCRIPTION: INS A1xL '��Of�IDUjT LJNDI R RbA O�aRVSTCE CTV
APPLICANT AGREES TO FURNISH THE,T04TN Q�F SOUTH,WIDS�OIH1;AM( CI1 ISQF SAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIYyPENSES I�CDB }IE i�} FO3v1A1NTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMIT✓IA$[ IVi
H` Np W1L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN`OFF SOU I I W SpR S STREITtGUT PERMIT MANUAL.
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ISSUED BY TED INSPE D BY
1/24/20172:03PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: 1 �l ' CONTRACTOR:_ ��` Yl �
LOCATION:
TYPE OF WORK: .1 C)
DATE INSP NEEDED: DATE INSP: ZLa7l
INSPECTED BY:
WORK IN
PROGRESS;
SEPTIC TANK PUMPED,SMASHED,FILLED WITNES'5ED ❑YES ❑NO
AS-BUILT:
INPUT: DATE:_,�I.. 3 �..
S/molloyJfonns 2014 Town or South Windsor INPSWa0WREP01Cr 14
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APPLICATION FOR STREET EXCAVATION PERMIT
r !. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT/06074 FEE $25.00
Name of Firm l� � Ll16ck�S Phone No.�°(8M_ �ql - 23o2
Address of Firm 1R {��itr S �fbQ f V)Ce lzj e---Zip Code 02a 0
Location of proposed work �'� S S'r��e �`f+� 9j.
Describe fully nature of permit requested 1 s�iii(� 21` Cd')Olin t O'Ackf ' If Oa a -0 SYKQt CP C Ai y
Starting date I t Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS, THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: L�1 No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /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 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 FAMI WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WI NDSOR'S EET T PERMIT MANUAL. }
Sig d: Print Name � �� �V>�� Date: 1 I l 20 1
St et Excavation Permit 2014