HomeMy WebLinkAboutStreet Cut Permits 58 Sele Drive (6) 1700078 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 05/02/2017 r
� t GIS ID: 81800058 FEE: 0.00
MUNIS APPLICATION# 201700462 EXPIRATION DATE:
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APPLICANT' '� t LOCATION
NAME: EVERSOURCE y
ADI)RE1 ` $.SELF DRIVE
ADDRESS: 112 PROSPECT HILI5�1�,�}t O 5 i' y t�WNERe FAO D&NNIS HAN&MICHELLE YBUNG
EAST WINDSOR,CT 66#l8 159 IaLE DRIVE
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}UTH WINDSOR CT 06074
PHONE ` ' �Yz '
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WORK DESCRIPTION: GA
APPLICANT AGREES TO FURNISH THTOla V QFOUTH1T1TpSpUT
HE AMcT TINT OF T3DND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY=IEINFS IIWOTxfI�I $�7 TtE IT NANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TE t�PEJ,IA�iT I `PAIIIAR WITHDyVI°LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN`bF S(}iJxH WII+IDSQk'S STREET CUTE17IVIIT MANUAL.
ISSUED BY DA E INSPECTED INSPECTED BY
5/2/2017 3.43 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NOS� �l {CONTRACTOR:
LOCATION: S e-\ ' �� v
TYPE OF WORK: ex
DATE INSP NEEDED: DATE INSP: ` ll
INSPECTED BY: S
WORK IN .
PROGRESS_; TA'....
SEPTIC TANK PUMPED;SMASHVD,FILLED WIl'NESSED ❑YES ❑NO
AS BUILT:
INPUT: DATE: 19, '
S/molloy/fonns 2014 Town of South Windsor INPSWt WffiP0U 14 _
APPLICATION FOR STREET EXGAVATiC�N PERMIT
Ap.pl.No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
Name ofrtrr } ►1aC Phone No. 0 "r " o4
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Address of F)ii': A r. Ip Code.
Location of proposed�w�ctr�t 1 x
,. . .., .
Describe fukly nature of permit red: C ,
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Call Before You Di Na
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PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS", THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER.THAN A YEAR.
Chook Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk,Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
i Show sketch of proposed work or furnish Indicate North , 414;0*f to be fifiled W 6y;.1J
two copies.of separate drawing
No.cuts.:.... .......... �
Est.Patch Size(s): sf'
Est; Pvt.Thickness..........:.:.:...::....::::::::.:in.
Ail Est.Patch Unit Price' fsf
Est.Patch Cost$
'-" Est.Curb Replacement ft
Est.Curb Unit Price
S/WW ?;Est.Curb Cost'.
............................................
Est.Sidewalk Replacement sf
r Est.Sidewalk Unit Price$ .. Isf
Est.,Sidewalk Cost$:.:::
Est.Traffic Hours .....�.,.... hr
Est.Traffic Unit,Cost$ _ /hr
Est.Traffic Control .
Amt,of DepositTh
$
DRIVEWAYS must be aft or more from the property line per t Total Due
section 21.7 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 SOUTRWINDSOR 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 FAM., WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS:AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR S CUT PERMIT MANUAL.
Print'l�am f .F' Date:
Streek Eitfiav,,ptF Permit 2014
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Tha material contained on this map Title'
shall he considered proprietary to i
Eversource Energy and user which it
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defined as any person ora entity " • .... {/�
who has reGetved the mop through � u �+
Information shown is not uargntee and Everaource Energy
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sale;piirchbse,exchange,gift,or t'assumes no respgnsibility.g Cant'fap rs:are urged to call 9y
otherwisa)shall keep it m confidence .Eversource Energy for further ih4drin on at 1-800—M-0900 ENERGY
and shall nat furnish or disclose it
to any.third pony withqut the prior
.I writtari armission of Eversouce En 7 Ploklad:19—Rpr-2017 .Ey:gisawrt
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