HomeMy WebLinkAboutDrain Layers Permits 87 Kelly Road (2) 1800034 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 05/21/2018 y
GIS ID:49500087 \ FEE: 0.00
MUNIS APPLICATION# 201800735 "Y4? »` EXPIRATION DATE: 06/20/2018
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APPLICA r«�
NT LOCATION
NAME: ENVIRONMENTAL );R`/16 EIS INS APDR$ S �$7 T{EL ROAD
ADDRESS: 90 BROOKFIELD S�'R "E1 OWNERVA EIS SCOTT A&KIMBERLY K
SOUTH WINDSOR,3C�T�06U74 8`1 KBLLY ROAD
WINDSOR,CT 06074
PHONE 860 52 �5II0 v} 3
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WORK DESCRIPTION: EXTENT? . . pNE 'IPE TO LATERAL PAR T( W Of§b JtH WINDSOR
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NO FEE `
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THE DRAIN LAYER ASSIGNED TO THIS~'F VIITLkIa�1S A VALID�I ENSEs SSid11 S$�'THA STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FOR H TN THE ATTACH DY`CQ7dDITIOI�TS', 'A L)PORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS;AiL L bSfTA R1;(�UIRE1b1 1T'S, ?kNl�TEE ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
5/21/2018 3:13 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT_
PERMIT NO.: S ?-3�'I CONTRACTOR: d1/L(-Od I �Yf � �'1 4e s
LOCATION:
TYPE OF WORK: � P_jzC7 0��
DATE INSP NEEDED: DATE INSP:_ Z-alLllly
INSPECTED BY: n
WORK IN
PROGRESS: 6;
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SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑-YES ❑ NO
AS-BUILT:
INPUT: (�`(`� DATE: ,
S/Moiloy/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 $50.00
Name of Firm Phone No. LO 50ff 35 W -_
Address of Firm n. t� i s� c^ Zip Code BS c J- =! -
Location of proposed work_ z -7 k c l ,i k�2
Describe fully nature of permit requested yv; r a
Starting date "S' Call Before You Dig No7f'�
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: X.No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑Curb Cut ❑Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: Public Water ❑Well Sewage Service: ❑ Public Sewer [] Septic
Show sketch.of proposed.work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est.Patch Size(s) sf
j Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
1. Est.Sidewalk Replacement sf
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Est.Sidewalk Unit Price
Est.Sidewalk Cost$
- Est.Traffic Hours hr
Est.Traffic Unit Cost$ Ihr
Est.Traffic Control$
DRIVEWAYS must be 3ft or more from the property line per Amt.of Deposit$
section 2.17 of the zoning regulations
Total Due$
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES ( )Cash O Check#
Paid By
I AGREE TO FURNISH TO HE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY
EXPENSES INCURRED BY CH WN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ASIDE BY
THE RULES AND REGULAf ONS OR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STIR TOUT PERM T MANUAL. f
Signed: _ Print Name 6 i l iE=���f Date: zD
Engineering/per its/Stree , tlon Permit 2017