HomeMy WebLinkAboutStreet Cut Permits 206 Bourbon Street (3) 1700033 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/17/2017
GIS ID: 12300206 k
FEE: 0.00
MUNIS APPLICATION# 201700235 = �5
� . EXPIRATION DATE:
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APPLICANTt LOCATION
NAME: EVERSOURCE r, ADDRE OBQURBON STREET
ADDRESS: 112 PROSPECT HILL R , OWNI R s Wt1LLY- FRANK&JACQUELINE J
7
EAST WINDSOR, 5'MERIDA CIRCLE
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T Er I ALAGES FL 32162
PHONE N'> .
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WORK DESCRIPTION: GA i SE VIA R.SIDEWALK
APPLICANT AGREES TO FURNISH THTOV4NQF'SO`J t HWjaiD TIIE; VIQNOF IpND REQUIgED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC XPIrFS TTURRED B >IE I`Q�VN k,ORI�IAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND'IAI$A1"P.IGANT IS�AMI IAR D WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WN'b SUTIIWIS{I ':S S I'R1ET Ci7TpLIMIT MANUAL.
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ISSUED BV, INSPECTED BY
3/17/2017 10:26 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPEC OOK REPORT
PERMIT in. % 7 CDNTRAMR:_ '��Gf 0 �^ce
LOCATION: '54yreT
TYPE OF 1NORK; �
DATE INSP NEEDED: DATE INSP. r%
INSPECTED BY:
WORK IN .
PROGRESS rS'v- r
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SEPTIC TANK.PUMPED;SMA$HED,FILLED WITNESSED ❑YES ❑NO
INPUT: DATE• \
S/molloy/forms 2014 Town of South Windsor INPSEcWITREPOlff 14
APPLICATION FOR STREET EXCAVATION PERMIT _
App1.No. TOWN OF::SOUTH WINDSOR PUBLIC WORKS DEPARTMENT l'ermif No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00
Name of f=t ir! . ' d t—AiA C Phone N
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Address of Putt .� -�'' �:... 1 ��, , . • f :Code,
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Location of proposed Wn&:
Descri 11 be fully nature of permit>equested T - �'� ' F'V/C
- Call Before You Dig No - "
Starting date,„ -
:........:........_.,...,::....
I�1�M1l�Y' ;Ttf+n XV THE
P ;�ICltt'J ,"I'H�U1tFt�S[I'�C�t�THE FTNl10.NEhl'C�'Au�MENT P:��1 CFFR,#�EO CU.R¢Rt�i�Ll!1��fir4�t�'�fb"yA.('I1�4.fMi.
I' tVT i ,141;SPttSfal.B FOR'THE;FULL l=1NA�CQSTOFTHE l'EfiNtAt�Ef��`f'ATCI�AND Cll #0 SEptAGPMEM•.•iNLUbttGA4 Y'
fttll�l=,fc+�F$[I�t RAI"C.f�`AI�t*Itt,�.I�FIO.t:>r�1Csi'I�,, ;'1�Afr�l�,iy�I�tTROL 11Nt�`1'ilG'►'t�WN'�F.C1�ITfiACi;1'CC1�'�as 7`ME P�RII±I'1�1+#E1+f�'1�1�T€.'�t{S
TYPICFILLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE:LAfi=R ffiAN A YEAR.
Check Applicable: 11 No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut :;_..`.Sidewalk Out
❑ EXiistipg 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 l hTs saCitdn to be tilW_dut=wybma
two copies of separate drawing
•
No.cuts.
Est. Patch Size(s sf
Est.Pvt:Thickness. in.
7
Est. Patch Unit Price$.. ...... 16f•
:. Est.Patch Cost:;
Est.Curb Replacement it
Est.Curb Unit
I Est.Curb Costl_.-:.;
;s
ai Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ Isf
Este Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ Ihr
Est:.Traffic Control
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Amt.of Deposit$. ... .... ........ ,.... ._.�,.:
DRIVEWAYS must be aft or more from the property line per Total Due$,
T.
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 JCOBSITE 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'T'HIS PERMIT AND
THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES.AND REGULATIONS FOR PERMITS AS:OUTUNED IN THE TOWN OF SOUTH
WINDSOR'S STREET CUT PERMIT.MANUAL.
� -�' Pnnt Narne � '
Signed Date:
Street Excavation Permit 2014 6 7 7— D �e
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The material contained on this map Title:
shaft be considered proprietary to '
Eversource Energy and user (which is
defined as any person or entity -=-= - '
who has received the map through j�.:. -
-defitid �titsrifn is not gua�'�thff— mod• Eve esur+p'e Energy
sale; purchase, exchange, gift, or ' { � � --
otherwise) shall keep it in confidence u- a 'c �'�ponsibRC
ility. C tda+-F.s are urgent EQ call C 1^ ,
and shall not furnish or disclose it purge• Esteri y for further inn ast»3 tsa i' at I'=$Q -989-0900 ENER1.�i
to any third party without: the prior ..--= . .
written per of Eversouce Energy: Plotted. 10-14on-2f)t7 fay. gisewrl w