HomeMy WebLinkAboutStreet Cut Permits 500 Clark Street (3) 1800056 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
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DATE: 05/24/2018
GIS ID:20400500 `' FEE: 50.00
MUNISAPPLICATION# 201$00757 �c ri sXPIRATIONDATE: 05/24/2019
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APPLICAI � .�, ' - LOCATION
NAME: HOMEOWNERt � i DD �C RK STREET
ADDRESS: SOUTH WINDSOR, �4 TREE FARM LLC
CruI., RK STREET
PUT INDSOR CT 06074
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PHONE
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WORK DESCRIPTION: RE D, S FN I 0 STORM WATER
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APPLICANT AGREES TO FURNISH TH O :OUP F ?ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FORA EI � kT ?IMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T' T iLL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN SQ. � TL�P IT MANUAL.
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ISSUED BY J TED INSPECTED BY
5/24/2018 12:47 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: f �n CONTRACTOR:
LOCATION: SAD 0 C
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:_^ z''
WORK IN
PROGRESS: l4
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:— (� I�'v DATE: '
S/molloy/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 $50.00
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Name of Firm ;f�'`" r 1`A, ' 0 Phone No.�7...
Address of Firm 5 r� J�� tic, u� Zip Code
Location of proposed work
Describe fully nature of permit requested
ptvn W`Atr ;�0A loci
Starting date GI i I K Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES.IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: dNo Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑Sidewalk Cut
. r Existing Driveway, No Changes ❑Proposed Driveway Widening ❑Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer CJ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by
two copies of separate drawing
y 11 o-A�, No.cuts
Est. Patch Size(s) sf
y
Est.Pvt.Thickness in.
Est.Patch Unit Price
%h} �}4,)a✓ SskkWP Est,Patch Cost$
W—'M \ Est.Curb Replacement ft
Est.Curb Unit Price$ Ift
L_w w ac:_ Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est,Sidewalk Cost$
Est.Traffic Hours hr
ALA CLUB 1 La E T Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
DRIVEWAYS must be aft 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,_.
€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 THE TOWN OF SOUTH
WINDSOR'S STR7- c
T CCRMiT MANUAL.
Signed: n il Print Name w 1, %A Date: S
Engineering/permits/Street Excavation Permit 2017