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HomeMy WebLinkAboutStreet Cut Permits 130 Diane Drive 1700223 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 10/23/2017 y GIS ID:28200130 FEE: 50.00 MUNIS APPLICATION# 201701494 4`` „ EXPIRATION DATE: qk APPLICANT LOCATION NAME: EVERSOURCE ADDRESS 13(?DIANE DRIVE ADDRESS: 112 PROSPECT HILL ROADTFHBOl?EAU DONALD R TR& EAST WINDSOR,CT Q�6088 1 Q DIANE DRIVE S }I7TH VITINDSOR,CT 06074 PHONE WORK DESCRIPTION: EX OVATE OT.00ATE/REI$ TI IN I.B IC`�Lx1S 2 WONE721974 APPLICANT AGREES TO FURNISH THE�TOVN OFpUT�I WINDSOR TH1;AMOUNT`QF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AN,.,f',`EXP NES INCTJRREI)BY THE TpWlkf FOROMAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND TF APT ICANT IS FAMILIAR VPH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOTJTH DS R':S STREET CiJT PERMIT MANUAL. 1t0 ({ ISSUED BY A'I`E*SPECTED INSPECT D BY 10/2312017 2:38 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** s v k h T A t t� �y t U � S M i SL}A2 olk y h z„ TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 1 "]( D CONTRACTOR: LOCATION: 13 �i Vim. TYPE OF WORK: L,0C.a4e_1(e&,f fgiO 164k G h%< DATE INSP NEEDED: DATE INSP: INSPECTED BY: Bz) WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES NO AS-BUILT: f INPUT: DATE: i S/mo!!oy/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 $50.00 Name of Firmn Phone No. Address of Firm I lja=o f - Zip Code 0099 Location of proposed work 130 CYI Describe fully nature,of permit requested 4n bm �Q �Gtll4 2.. Starting date Call Before You Dig No 6� 1 v3 PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES,IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut ❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing 0 No.cuts Est. Patch-Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price$ /sf Est. Patch Cost$ Est.Curb Replacement ft Est, Curb Unit Price$ !ft 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$ DRIVEWAYS must be 3ft or more from the property line per Total Due$ section 2.17 of the zoning regulations - O Cash O 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'S ST T PERMIT MANUAL. Signed: Print Name—A, C W� Date: f Engineering/p rmits/Str t Excavation Permit 2017 ad 1::� EUERS'�URCE LEAK GLAssll ti'.ATioIV. z a ❑ ❑ LEAKQE REPORT IIIIIIIIIIII IIIIIf ICI IIIIIIIIIIIIII IIII ELOW GROUN© STATE 0 CT 0.1171A ": B � 261865 DATE L4K'.FQUND. ✓ - #. TIME.�+ r r7 ��.�• For foilow-up work on an existing.ieek enterexisting: •PRE=EXISTING LEAK REPORT CLASS 7:-INFORMAF IQN Normal Hrs I�y MAIN:T ENANCE Time Reported to:Dispateh: Time Ort!Sitei - Lam❑' ALL GLASS ONE{.)�LEAKS AF2E T(YB REPORTED IkNMEDIATELY Consult is to standby for Eversource - WrrtR`-SERVICESED ` first'responde[snd.assist furtNei'if needed: AWGIDISTl�1CT. C -. 4'V•:)_IV P e A.'_ TOWNICIT.y � . �1 r#112 LOCATI0.19.^� /. i l 1� }`,l i< D �k X ST{s)^ t" .Y q t:Fa�t t.gt� i ;•tJ -INCIDENT TYPE METHOD SURVEY TYPE -LEAK REPORTED BY USED Business Distnct walking Gas Leak Customer Flame Ion business.Districtmobile Damage With Power Equip-Gas Leak Leak,Consultant. C.G.I ClWinterPatrol Excavator INSTRUMENT ID: .. 1�;;'" ��f J`�k' +31 ' Mobile Fire/Police CALIBRATION DATE: € :.Pre pave Passerby LOCATION OF LEAK HIGHEST READING Co Employee LEAK.APPEARS. Public Bulldiit� TO BE ON r� Street FOUND Other LEL Re Cheek Main Sidewalk S ecial. :, GENERAL LOCATION GAS ,f p. Service Lawn. Walking } Public ROW Valve .. School(within Oft S Zone), AREA MARKED, Private Property Business District No -White, No Reading, 2 C�' _i i 3 1 ? 4 5 i S IN B .. 8 1 } 1 NFd 9 13 C) M}t � f` 14 15 . (} 17 4:1 �w ► N I, �' 1 `fu i 19 C/ I .,.. b - 22 j c 23 Include all pertinent information•-type of cover,sewer or drains in area,etc. q-7 C/l/r_ , ADDTIN : l IOAL INFO `�I\ ' 0- t')0 j I � � Y..r •% ` Leak Investigator's Narrte,_,,,,... Company Name(if Vendor) -� r Si9ervisor Suup 's nature Leak,lnvestigafor's Signature Dab �,�- ,...r . .-