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HomeMy WebLinkAboutStreet Cut Permits 19 Scantic Meadow Roa (3) 1700243 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 12/20/2017 GIS ID: 81000019 FEE: 50.00 MUNIS APPLICATION# 201701853 EXPIRATION DATE: ' F gS h rco �.'.' APPLICANT y w aQgLOCATION NAME: EVERSOURCE ADDRESS 19 SCANTIC MEADOW ROAD ADDRESS: 112 PROSPECT HILL,I6b QWNER MCGgAW SANDRA L EAST WINDSOR,c60s. geo1 9' A*TIC MEADOW RD r5 4 > SQUT H"WINDSOR,CT 06074 PHONE ' : Y WORK DESCRIPTION: EMERGIJT�GY GAS LiiK ON'SERVICE ,, r kv;, 'i k! APPLICANT AGREES TO FURNISH 1'HE3TO)W OV:SOUT I 1 INDS R THE A1V O IVT OF) O1VD REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR 'EXPI 1VS`ES Aht Il�(CURRED EY THi; TENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND APPLICANT IS F�MI,1AR WiT1I AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN&F,SO'[JTH WINE)s R'=S ST E GUT FERMIT MANUAL. fw i o �' ISSUED BY DA E INSPECTED INSPECTED BY 12/20/2017 2:23 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** fi}!ram �r , 14 u Lsf h r � if f TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: ©d V3 CONTRACTOR: LOCATION: &0 TYPE OF WORK: �-t 0 0 c-c,' DATE INSP NEEDED: DATE INSP: Z Lz e , INSPECTED BY: WORK IN r PROGRESS: Lf .-s• ree f cvl �;t:� ,G' ��� /� � •�"' G.,.L... � ,tip rP l'it SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ONO AS-BUILT: INPUT: DATE:_�T 1 S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14 AFFLIUATIUN FOR STREET EXCAVATION PERMIT Appl. No. TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 1640 SULLIVAN AVENUE Date:/ 'y / 7 SOUTH WINDSOR,CT 06074 FEE $25000 Name of Firm Phone No., ..z a � Address of Firm f LLr Zip Code�> Location of proposed work�l«i - Describe fully nature.of permit requested LM Lk E.go Starting date / -% 17 -Approx.time for completion I W 1 T/ "7 Cali Before.You Dig No.` c) D p 70 Existing Water Supply: ❑Public Water ❑Well Existing Sewage Service: ❑Public Sewer ❑Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A -PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWNS CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLtr fEU rrifi'THIN A*YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. -Show sketch otproposed work or furnish This section to be tilted out by two copies of separate drawing: lndicate.North Town of South Y indsor 0 No.cats Est Patch Size(S) sf Est.P.A.Thickness in. Est.Patch Unit Price$ /sf Est Patch Cost$ Est Curb Replacement ft Est Curb Unit Price$ Ift Est.Curb Cost$ --. -- Est.Tramp Unit Cost$ fnr Est.Traffic Control$ .� Amt.of Deposh$ Total Due t6 '4Gfl:"t..)LV emu" (.)Cash { j Check#. Applicant is responsible for contacting Paid By the Police Dept.and C.B.Y.D 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,T' OWN OF SOUTH WINDSOR'S STREET CUT PERMIT UAL. Signed: �G '�V'� t.� Date: h-- l 7 Title: a t, Driver's License#: PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMrr WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED . PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES Street Excavation Permit 08 REV 10-22-08 c3: a �9 O 19 e s y rn 0 v W ' @ 30(nts) O EB �X 3� w m 0 GJ .A O b Q � a _ cn rn 'v a io w u" o 1G m_ V 7 C+ m N UN The material contained on this map Title: shall be considered proprietary to Eversource Energy and user(which is defined as any person or entity Ot s /fir /+�►� Ri/+► who has received the map through 9 gy E Y ERV���\ti�E sale,purchase,exchange,gift,or Intormatian shown is not- uaronlead and Eversouree Ener otherwise)sholl keep it in confidence assumes no responsibility. Contractors are urged to Coll ENERGY and shall not furnish or disclose it Eversource Energy for further information at 1-800-989-0900 ENERGY to any third party without the prior written permission of Eversauce Energy. Plotted:04—Dec-20$7 I BY:9isswrl