HomeMy WebLinkAboutStreet Cut Permits 125 Pine tree lane 1700158 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/02/2017
GIS ID:72300125 t FEE: 25.00
MUNIS APPLICATION# 201701025 EXPIRATION DATE: 08/02/2018
APPLICAI T�'4, WK 3 a LOCATION
NAME: QUALITY PAVING O ADDRLS 125 PIXIE TREE LANE
ADDRESS: I94 S.MAIN STREE�i �� r OWNIyR BELAID NORMAND R L/U&FRANC ES R
EAST WINDSOR,CTx0608$ 125 PINS TREE LANE
r f Z SOuT,, SOR,CT 06074
PHONE 860-523-4182
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WORK DESCRIPTION: DRIVE�WAI{
4 rt� a.
APPLICANT AGREES TO FURNISH THTOWN OFO TI#WINpQR xf AMOfiJNT,zOF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AI�iYfE-XP29SES INCURRE} BY THI TOWN FOIE MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T IJ L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO IT MANUAL.
ISSUED BY DACE"IlPECTED INSPECTED BY
8/2/20I72:39PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
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PERMIT NO.: CONTRACTOR: Orik"?i c
LOCATION: a
TYPE OF WORK: v`C
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: >r�
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED [:] YES ❑ NO
AS-BUILT:
INPUT: DATE:_
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl.No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
WN HALL 9$40$QLAIVAN AVENUE SOUTH.WINDSOR,CT 06074 FEE $25.00
Name of Firm P one Nld.
Address of Firm ✓r!-i't/ '� Zip de
Location of proposed work
Describe fully nature of permit requested u
Starting data —If Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT is A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COU0'BE LATER THAN A YEAR
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut Cl Pavement,Cut ❑ Curb Cut ❑ Sidewalk'Cut
XE)dsting Driveway;No Changes ❑ Proposed Driveway Mdening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled outby Town
two copies of separate drawing
No.cuts
r~~ Est.Patch Sizes) sf
7 Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement It .
V
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.TraOio Control$
Amt.of Deposit$
DRIVEWAYS must be 3ft or more from the property line per Total Due$
section.$.17 of the•zoning'regulations
( )Cash ( )Check#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
PERMIT SHALL BE KEPT ON dOSSITE 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 FORANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIRWORK IN CONNECTION WITH THIS PERMITAND
THAT I AM.•FAMif�tAR;WITH AND WILL ABIDE BY THE RULES AND_REGULATIQNS FOR PERNTS AS OUTLINED IN THE TOWN OF SOUTH
VANDSOR'S STREET CUT PERMIT MANUAL.