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HomeMy WebLinkAboutStreet Cut Permits 12 Drake Court 1600012 PERMIT NUMBER TOWN OF SOUTH WINDSOR, CT P STREET CUT PERMIT DATE: 03/17/2016 GIS ID:293000I2 MUNIS APPLICATION# 20160025IFEE: K i xXPIRATION DATE: 25.00 03/17/2017 APPLICAI�iT i y LOCH NAME: TELE-NETWORKS 4 ADDRESS I2 DRAKE COURT ADDRESS: 31 BAKEWELL COURT ' t OWNED SOORtSOWMIALAKSHMI& CRASTON RI %02921 < I ` 1 I�RA1KE COURT PHONE 401-461-9420 `K - r y i SOUTH WINDSOR CT 06074 Sp i j in" WORK DESCRIPTION: LAGEXIN CATS+'%v a i ,, ij 2ir '�i c APPLICANT AGREES TO FURNISH THF 'O�Ik©FAN�OLIKI'I`QOF BAND REQUIRED AND TO REIM$URSE THE TOWN OF SOUTH IS PER R FOR A f�I XEI i ,SE INCU FaR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND T r I FOR PERMITS AS OUTJ�LIN/E�D IN THE ®TOIDE BY WNWN C}Fb IND�a L$TUT PERMIT MANUAL.THE RULES AND REGULATIONS IR ISSUED BY DATE IlMPECTED(V INSPECTED BY 3/I7/20169:44AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ------------- `#" �. c :k fi t xs L' i � I j y S y 5 5 ' y PsO} 1 S I ti 1 0 .nNA i et:. TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO:: C�o001a— CONTRACTOR: /� ✓^ � LOCATION: e e w f- TYPE OF WORK: J� DATE INSP NEEDED: DATE INSP: i Z-/,f f t� INSPECTED BY: f?� WORK IN PROGRESS: _. SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO AS-BUILT: INPUT: DATE: S/molloy/forms 2014 Town of South Windsor INPSECTION 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 $25.00 Name of Firm -rele-Al kwyrks —Phone No. Address of Firm 31 8ca °I C J- zip Code 09 c'l;L I Location of proposed Work /,� Occ.ke C Describe fully nature of permit requested Starting date I- G Call Before You Dig No n/6 llG a-I y4 PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: 54- No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut ❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing No.cuts See A -Iaole 0 Est. Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price Est.Patch Cost$ Est.Curb Replacement ft Est.Curb Unit Price Est.Curb Cost$ Est. Sidewalk Replacement sf Est. Sidewalk Unit Price$ /sf Est.Sidewalk Cost$ Est.Traffic Hours hr Est.Traffic Unit Cost$ /hr Est.Traffic Control$ Amt.of Deposit$ Total Due$ ( )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 WINDSOR' STREET C PERMIT MANUAL. Signe t�� U �"'' Print Name Date: Stre t Excavatlgn Permit 2014 4!U - — _f� X Fife Edit l3ill'ing Services Cuitorraer.Information Order l:nry r pP1t Financial =History ;°HSD ;Help I f OK Acct Nbr 433627-05 Task Exit heriheran kuppuraj Co/Dv/Fm 51 10 426 Cust Info Prt Vi 12 Drake Ct Phone# Home 860 627-7902 View 2 South Windsor, CT 06074-6902 Bus Tech# 0 0 Code 0 BURY DROP Job Seq Priority 5 Pool J Job Nbr 000 Tag Nbr 696430 Menu ■ Work Order Number 20SS5728 Problem Code Work Order Type SR Special Request Addtl Problem Codes History Work Order Status Not Coded Primary Finding . Dispatch Comment Primary SolutionTime Slats . Work Order Comments Pri Loc sur3 Prorates Sec Loc Sch Date 5/15/16 --- _. Flash Sch Time ALLDYI Node ID S!063 Comments Ckin Usr Stage C l Vt3GDROP LEG DROPT�IK 1 .O0 67859 J.SIR�I hL Co eotit�urlrcat�ons �" n r�r L!�J-��5./( rLo✓ �1 �'n I'-,i C F �o t'cx�Sc C