HomeMy WebLinkAboutStreet Cut Permits 100 Overlook Road 1800078 TOWN OF SOUTH WINDSOR, CT .
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/2I/2018 �s
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GIS ID: 67500100t��5F FEE: 50.00
MUNIS APPLICATION# 201801033 o t 11 ,r y v 1 r ,Wti Y
� �pIRATION DATE: 06/21/20I9
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APPLICANT �7FA .
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NAME: QUALITY PAVING CO 10Q OVEOOK ROAD
ADDRESS: 194 S. MAIN STREET ��
EAST WINDSOR,CT 0 8` " M �y Y`r,� y rQ' NERP ;,3E�CARD H&LANE BARBARA B
x I00 E OOK ROAD
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SU `IIIDSOR, CT 06074
PHONE 860-523-4182
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WORK DESCRIPTION: DRIVEWUTA
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APPLICANT AGREES TO FURNISH THE T(1;. OUTI WINDSR TIAQLIITUIQNII�RE UIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY P 'NSES INCURR1lIc3�` I TENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THEE ICAI?I1,TS FAMER WITH Alp WDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF6010TfI W1NI��SOR',� TRI{ET gUT PERMTT;1tvIANUAL.
ISSUED BY T)AFINSP CDi'` INSPECTED BY
6/2I/201812:00PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 09.00
CONTRACTOR:
LOCATION: Q �2jfC tOl) k 26aj
TYPE OF WORK: I
DATE INSP NEEDED: DATE INSP: I 1
INSPECTED BY:
WORK IN
PROGRESS: s kc
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT: C:, DATE: , !
S/moltoy/fomns 2014 Town of South Windsor INPSEC71ON 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 $50.00
Name of Firm 9'(J-'ei �z% (Ier, Phone No. 5'z s 1�r/9
Address of Firm C'C-) Zip Code
Location of proposed work
Describe fully nature of permit requested % ae
Starting date '5 LIE Call Before You Dig No ��i� 2`f� I f 6 �
0 ^
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: L7 No Pavement,Curb or Sidewalk Cut 0 Pavement Cut ❑Curb Cut 0 Sidewalk Cut
Existing Driveway, No Changes 0 Proposed Driveway Widening 0 Proposed New Driveway
Water Supply: 0 Public Water 0 Well Sewage Service: ❑ Public Sewer 0 Septic
Show sketch.of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
1 ,/ Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est,Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
(,Z I Est Curb Cost$
y Est.Sidewalk Replacement sf
C Est.Sidewalk Unit Price
Est.Sidewalk Cost$
f lV
y C Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
DRIVEWAYS must be aft 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 SOUTHIWINDSOR'S STREET CUT PERMIT MANUAL. (�
Signed: G�'�rC' r �.'Z2iJti Print Name Y)6nr`y Date:
Engineering/permits/Street Excavation PerrrCV2017