HomeMy WebLinkAboutStreet Cut Permit 287 Strong Road 900123 TOWN OF SOUTH WIND
PERMIT NUMBER S O R; C T
ww STREET CUT PERMIT
DATE: 09/18/09 b <..
�M
GIS ID: 87000287 '" - «
MUS200901127
01127 �' ''} ' y �<.,, FEE:
M APPLICATION# 2009 25.0
' °'`' y 'L lRATIO 0
3: ; K` .f`>> •. <,x ; ,. N DATE: 09/18/10
APP
NAME: HOMEOWNERIc r r 410CATION
ADDRESS: SOUTH WINDSOR 0/4 4 . a � S`Tv�G ROAD
3 7 T
STRO
p W G ROAD LL C
'SiTZONG ROAD
PHONE4 TH x DSOR,CT 06074
WORK DESCRIPTION:
PRIVY`. 41
�,� `• s-' �.,
APPLICANT AGREES TO F "}URNISH THE Tb
�O :r :;. UN BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI� �� . C
CONNECTION WITH THIS PERMIT AND THEE, `� ,;'. fJ121VIAINTENANCE OR REPAIR WORK IN
API� �T TRIIJ'. 3LL ABIDE BY THE RULES GULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SJT�
/ ► ►D ' T �IIT MANUAL.
l n "
ISSUED BY DATE IN PELTED
INSPECTED Y
9/18/2009 11:04 AM *"* PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 9 00 �a 3 CONTRACTOR:
LOCATION: oZ g7 Jed h q �OctcQ
TYPE OF WORK: r 1 V a-16 C u--r Per /3 aco yed /US
DATE INSP NEEDED: DATE INSP: //X/m_
INSPECTED BY: !3
WORK IN
PROGRESS: /,
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: 1
W/2007 Town of South Windsor INPSECTION REPORT 07
d 009 0.. >.2_ APPLICATION FOR STREET EXCAVATION PERMIT W
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC.WORKS DEPARTMENT '
'1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm f ���T f�o meow t'� � 9 -el
Phone No. _
Address of Firm 57P c / Zip Code V6d?e-
Location of proposed work f
Describe fully n ture of permit requested •ti ¢
Starting dfe 1 Approx.time for completion
Call Before You Dig No. Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH 1S TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate.North Town of South Windsor
0 No.cuts
Est.Patch Size(s) sf
Al Est.Pvt.Thickness in.
Est. Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price
Est.Curb Cost$
Est.Traffic Unit Cost$IV L
/hr
Est.Traffic Control
J > Amt.of Deposit$
Total Due$
( )Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.D.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SOUTH.WIND FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH T RMIT ANDUWerIAM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLI E TO H WINDSOR'S STREET CUT PERMIT 7UAL.
Signed: / Dater
Driver's License#:
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08