HomeMy WebLinkAboutStreet Cut Permits 291 Avery Street (6) 1900117 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/25/2019
GIS ID: 06300291 FEE: 50.00
MUNIS APPLICATION# 20190154$ k ,EXPIRATION DATE: 07/24/2020
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APPLICANT k 'IvOCATION
NAME: AIROLDI'S INC. js ��DrZ?I S "4,29l`AVERX STREET
ADDRESS: P O BOX 71 $VIRLEY ANN&JAMES J
ti' 91�AkLT�Y TREET
SOUTH WINDSOR,CT 06-074 F kiJy C d y M1 y CSC i
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fR :� In i iir c 4 ns. �7$
WORK DESCRIPTION: DRIVEWEI ' ' s ., ' ;t r
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APPLICANT AGREES TO FURNISH THE TOVVN iQUTH''PWINDSC R IEAMQUI*T OF BOIIJD REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY>J IJNSES INCURRED E Y TfrE TO I�1 F'OR'5ATN PENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE MPLI&ANT IS FAMII BAR WITH AND WILI; B I)E BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WM SOR'S.9TI�EET CUT P RMI1}'1VIANUAL.
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ISS ED DATE Il'�TSPETEI INSPECTED BY
7/25/20191:26PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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110"O F SOUTNf WMpm! lmsv.ECnON REPORT
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PERMIT NO.: CONTRACTOR:.
LOCATION: d`
TYPE OF UVORK: . "
Wt WSP NE DEI ; DATE INSP:. ILI , °,
INSPECTED
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PROWESS: . %�s oic
SEPrTICTRAfVK PIJMPEQ,,5MASHED; FILLED WrMESSED 0-YES Q NO*
INPUT: DATE' �
S/moitayrows M4 Tan of Sauk Windsor INPS N REPOW 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 $50.00
Name of Firm Phone No. �&3 6G-0))3
Address of Firm C Zip Code 130 1
Location of proposed work Sao
Describe fully nature of permit requestedN �-
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Starting date Call Before You Dig No �� �-- v
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: El No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑Curb Cut ❑Sidewalk Cut
L�7 Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic
Show sketch.of proposed work or furnish Indicate North This section to he filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ 1hr
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 ( )Check#
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 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 STREETfCUT PERMIT MANUAL.
Signed: ) �3 � Print Name 'L �°t'�` � � �"' f Date:
Engineering/permits/Street( cavation Per It 2017
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