HomeMy WebLinkAbout295 Rye Street - street cut permit 1900126 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 08/05/2019
GIS ID:78600295 ;1 FEE: 50.00
MUMS APPLICATION# 201901682 YY' F`' XXPIRATION DATE: 08/04/2020
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APPLICAN
LOCATION
NAME: TELE-NETWORKS *r
� � F� i ADDRES`$, 295�R�STREET
ADDRESS: 31 BAKEWELL COL t w ' f7�Ui[NER ALpI.I1C
ri a� 1 $03460049 DEPT 501
CRASTON,RI 0292 5, ' ' 2
PHONE 401-461-8420 " a�le;e'll 55
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WORK DESCRIPTION: 1N5"I'Aki' fhi+ 22"COND�71'I FOR.00�1�f1 5t"
APPLICANT AGREES TO FURNISH THE190ft OI+310i�TII{ DSOR THE AMOUNT cJr BdND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AII� CP1;I+TES INCIREDi�YI C?1�VI�FpR,MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND Th AI'fimICA�IT IS�AMIL AR 1� I A ID"WWII 1 ASIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN C3 50U1I'I WINDShcIr'.S STRI1 GUT IT MANUAL.
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ISSUED BY DAfiE`'INPECTED INSPECTED BY
8/5/20191I:52AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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T. IV OF S�U1'N WIN It ANN CtiON REPQRT
PERMIT NO.: . CONTRACTOR::
LOCATION:
TYPE OF WORK:
DATE INSP NE61E P* L Da?E INSP:. .
INSPECTED BY:
WORK:IN
PROGR S: �% i Y <s � l- u .
SEPTIC TANK PUMPEQ,SMASHED; FILLED , WITNESSED EYES NO
AS-BUILT: •
INP4IT: -' DATE: -
/malio�lJlromns M Town Of SCUM Windsor•MPSEC1 MN REPagr 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 $50.00
Name of Firm �e e W D t�S Phone No. b r 6 0 3
Address of Firm_1 S Nl Pat K S , Pra i e�e t�T Zip Code
Location of proposed work 2 5 (2-41e
Describe fully nature of permit requested 4✓1 S (�I I'1 2 ('or1 -� v- COAX"
Starting date ' S ' ( Call Before You Dig No 20 Iq 316 33 D
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETE;No
IT IN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
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No. cuts
0 Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
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
O Cash O 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
WINDSOR' S REET UTiPERMIT MANUAL, �,,/� )n �j
Sig6eeringi
r `' Print Name rV l S V �' f� Date:i A J
Engrmits/Street Excavation Permit 2017
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