Loading...
HomeMy WebLinkAboutStreet Cut Permits 14 Windsorville Road 1600223 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 12/21/20I 6 - GIS ID:95700014y FEE: 0,00 MUNIS APPLICATION# 201601861EXPIRATION DATE: tia c'14i�+C, APPLICANT F A fia LOCATION NAME: CONNECTICUT WATER COMP .W" ADDRESS x1�WI'TDSORVILLE ROAD mo ADDRESS: 25 NORTH ROAD Airi � 'J4 OWNRrI� SAWE MARIE L EAST WINDSOR,Q-T- 06�08 : = }, > a A } IlDSORVILLE RD WINDSOR,CT 06074 PHONE 860-623-3355 i ' r, $ D�+' £ L 1 'j 3 1 F t t r !!IFS WORK DESCRIPTION: EMII�E1V '�Vt7�,TERCI;f CCIEC1I 1~+C)R CRY WELL COvlwTTOISIADFs� F RXTREµ ; s ,.y4h, x it .! ky2 y" APPLICANT AGREES TO FURNISH TH O�1P�Irt1UfN�3 [�I3E')U40 N pF t7ND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR Y �L1SESiCCJRItE1 BY'THE (WI F�RVIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND E#P-.,d0ANT JS IL<IAR i 7Ii AZ D�( I L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINE/)IN THE TOWNbf SQI TH 1 TND�' STRI$T�CUT ETxZMIT MANUAL. ISSUED BY D INSPECTED BY 12/21/201611:02AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ------------ d_e4 F { TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 1 . 0J CONTRACTOR: LOCATION: J � Wti l!qd ocv die ioad TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: 1 [.�w -e ✓vt. Q G� 7 S MCI izvc f SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION 5 1 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 $25.00 Name of 4- :1-c/ �-.r�',r�'' ...� Phone No,_g( 0 qa - - Address of, Jrm I /fix �'S 7 '. �'r-IA Location of proposed World / �'. s=t Describe fully nature of permit Ab.�. � .: Starting date A W't} Ca11.Before You Dig No ffia r " PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE: THE APPLICANT 18,RESPONSIBLE FOR;THE FULL FINAL COST OF THE PERMANENT PATCH ANDCURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT.COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: ❑ No Pavement,Curb or Sidewalk Out ement Cut El Cut 0 Sidewalk Cut pav I ❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening CI Proposed New Driveway W #ea Supply;_- u [io Watar. 0 Wtflt ewagi®`S afire;: : . ':,uftitic Ei rire © 5ep1 Show sketch of proposed work or furnish Indicate..North This section to be filled out by Town two copies of separate drawing. No.cuts :. . -�,�/ /� Est. Patch Size(s) sf Est. Pvt.Thickness . __ .in. Est.Patch Unit Price* �`g( Est.Patch Cost$. Est.Curb Replacement:. ft Est.Curb Unit Price$ /ft Est.Curb Cost,..$ Est.Sidewalk Replacement sf Est.Sidewalk Unit Price$ /sf Est.Sidewalk Cost t; ............. ..... Est,Traffic Hours .... ....._Itr Est.Traffic Unit Cost$ SIG ......—......... Est.Traffic Control:. .:.:...:::..:-,.u.::..:::...,.... Amt.of Deposit$ Total Due;$; ( )Cash ( )Check#_ ,r 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 W.LLL gB.IDE-BY THE RULES AND REGULATIONS FOR PERMITS AS'OUTLINED IN:THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANPAL Signed: ......'� -- .: Print Name Street Excavation Permit 2014 ' ' M - - J -: Woe' •� a6 :••-: • ,• •sx w•d � ~4.� .. ... ���' Kits ,,.• ��:.... ., .. s ma c 7 u t LatS d� Jc .yn ca :w .,_ G,tc't'i�Gla`} r y c/ "as zar .. .. " .. .. .. f ::. ++�yj�QQ iy v �c