HomeMy WebLinkAbout588 Niederwerfer Road 1900028 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 04/16/2019
GIS ID: 63600588
FEE
50.00
MUMS APPLICATION# 201900682 iEXPIRATION DATE: 04/15/2020
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APPLICANT OCATION
NAME: EVERSOURCEADIIZRESS 58$I IED9VLWERFER ROAD
ADDRESS: 112 PROSPECT HILL ROAD I OWNER ^ S?rRRIS�1LtXANDER E
r= x' Y I�CIEDERWERFER ROAD
EAST WINDSOR,CT 06088
PHONE r
WORK DESCRIPTION: INSTALit GASS: Al
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APPLICANT AGREES TO FURNISH THE TOWN10FvS1�UTII W1NL)SOR THE AM UNT O&BOND , QUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E IIVCURR)vb=BY TIE TO WI�i FQRfiINENANCE OR REPAIR WORK IN
CpNNECTION WITH THIS PERMIT AND THE APISL IA1VT LS FAMII SAR WITH ANI)W II> .VI3IbE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED INrf)/Ts/HE TOWN OF SOUTH WIIVDSOR'.S/S.,T.. ET CUTI'ERMI'Iy 1-IANUAL.
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ISSUED BY DATE INSPETD INSPECTED B
4/16/2019 4:05 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH.WINDSQR INSP'E.F OM REPORT
PERMIT NO.: G�l.�
I � CONTRACTOR: 5
LOCATION
TYPE OF WQRK:
DATE INSP:•
DATE INSP NEEDED:
INSPECTED Blf:
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WORK..IN
PROGRESS'
HED FILLED WITNESSED ❑-YES ❑ NO
SEPTIC TANK PUMPEP,. . , ,
AS-BUILT: • .
INPUT: DATE:
iON t�PORl'14
S/moltoyJtorins 2014 Town Of South Windsor•MPS
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 $50.00
Name of Firm F-n Phone No. <a-
Address of Firm D Zip Code
Location of proposed work
Describe fully nature of permit requested rl
Starting date Call Before You Dig No 1cl 14 1)
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PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: 0 No Pavement,Curb or Sidewalk CJt ❑ Pavement Cut ❑ Curb Cut ❑Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement it
Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ Ihr
Est.Traffic Control$
Amt.of Deposit$
DRIVEWAYS must be 3ft 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
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
WINDSORMSTTRMIT MANUAL. II ''``
Signed: Print Name u)n Date:
Engirreedngjp rmi /Str t Excavation Permit 2017
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