HomeMy WebLinkAboutStreet Cut Permits 11 Pam Lane 1900177 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/25/2019
GIS ID: 68700011 FEE: 50.00
MUNIS APPLICATION# 201902160 x,'' , EXPIRATION DATE: 09/24/2020
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APPLICANT}x t{v' LOCATION
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NAME: EVERSOURCE � ADDRESS, 11 PAyM LANE
ADDRESS: 112 PROSPECT HILL., RU D { N R , `.. tVSSi~ L RICHARD W&
k s .E`' 41 f I"A11!I LANE
EAST WINDSOR, 0Uf� kG 8 f; t5v
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WORK DESCRIPTION: ECG VA I 'O nCUT GAS SERVICE AT CU, $VA`L'VE THEN RELOCATE WHEN
DEM I0. E REBUILT ':
APPLICANT AGREES TO FURNISH TI TOWN OR�SOI7TH 13 wx`I s. REQTHE AI1(10UNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN EXPENSItS�INCIJA.RRED`BY THE OWN kOSMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TE ApPI,TGAIVT IAMII IAR ViITH=AND�?I1TLL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWIVF SOiJTHIIVDSOR S STREET BUT PERMIT MANUAL.
ISS ED DATETVS ECTED INSPECTED BY
9/25/20193:0IPM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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T.0%"OF SQ�UTM.iARN SiQRINSPiEC�ON REPORT
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TYPE OF WQRK:,3,�
DATE INSP NEE01 : DACE INSP: ~� � —
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MPI Q 'SMASHED; FLIED WrMESSED ❑YE L NO'
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DATE:
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2014 Town of SOuth Windsor MpSkRON DEPORT!
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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 $50.00
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Name of Firm_ U kc Cc, C' 6S _Phone No, ^ Zf ,& —7 0 1-3
Address of Firm / P IZ p S e E c-7— H I !l Zip Code 0 6, 7
Location of proposed work
Describe fully nature of permit requested E?C Co-V,0N; G" ST 3 S E lCyl c-c
Starting date Call Before You Dig No�_ 0 1 g s (9 0 C� 9 9 1
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PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES,IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: -;ZDNo Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
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Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$ f
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
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
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Applicant is responsible for contacting the Police Dept.and C.B.Y.D }Cash Check#
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 STREET CUT PERMIT MANUAL. o
Signed: Print Name ,,,,'�'(t,e--)L G F,9 6 1�,f Date:_
Engineering/permits/Street Excavation Permit 2017
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The material contained on this map Title:
shall be considered proprietary to
Eversource Energy and user (which is
defined as any person orentity g 9y EVE
who has received the map
p through Information shown is not guaranteed and Eversource Energy
sale, purchase, exchange, gift, or assumes no responsibility. Contractors are urged to call
otherwise) shall keep it in confidence Eversource Energy for further information at 1-800-989-0900 ENERGY
and shall not furnish or disclose it
to any third party without the prior
written permission of Eversouce Energy. Plotted: 20-Sep-2019 By: gisewr1