HomeMy WebLinkAboutStreet Cut Permits 191 Hillside Drive 1700233 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 11/16/2017
GIS ID:43800191 FEE: 50.00
MUNIS APPLICATION# 201701642 =.:` u EXPIRATION DATE:
APPLICANfT LOCATION
NAME: EVERSOURCE ADDRESS I9'1 HILLSIDE DRIVE
ADDRESS: 112 PROSPECT HIED`ROAp OWNER = LARUE ALBERT A&SEENA L/U&
EAST WINDSOR,CT 06tf8�8 1�91 HTT?LSIDE DRIVE
PHONE t j SOUTH WINDSOR,CT 06074
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WORK DESCRIPTION: INS IsL A rSERVI E IN FRONT OF 194 GM&TAIGHT SIDE OF
191 w �
APPLICANT AGREES TO FURNISH THEM OR7N OF SOUTH V�I1�7DSOR THE X1VI0MT%q-F BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN,Y'EXPENSES INCU EI B1'THE TOWN,FS k-MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AIPLICANT IS FAM tmR' AlMiNUL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFFCI; TH W1IVDSOII'S STREET GUT PERMIT MANUAL.
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ISSUED B DATE INSPECTED INSPECTED BY
11/16/2017 1:55 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: / 7 CONTRACTOR:-
LOCATION: CI Ole, J) &L&=!E�
TYPE OF WORK: t S .5 en')
DATE INSP NEEDED: DATE INSP: t
INSPECTED BY:
WORK IN
PROGRESS: %:/�-r5'�
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: (,V- DATE:
S/molloy/forms 2014 Town of South Windsor INPSECfION 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 06074E�>
Name of FirmV - Phone No.
Address of Firm I 1 5 Zip Code r7(,0
Location of proposed work
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Describe full nature of permit requested V l f
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Starting date Call efore You Dig No rRn� 2)
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: El Public Water []Well Sewage Service: ❑ Public Sewer Cl Septic -9.3 (e m � Cs
Show sketch.of proposed work or furnish Indicate North This section to be filled out_bTown
two copies of se`larate drawing
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness _in.
Est.Patch Unit Price
Est.Patch Cost$
4
Est.Curb Replacement ft.
Est.Curb Unit Price$ /ft
3
Est.Curb Cost$
i Est.Sidewalk Replacement s€
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
C6 (J T Est.Traffic Hours hr
t 3 77 i Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
DRIVEWAYS must be 3ft or more from the grope tine per Amt.of Deposit$
section 2.17 of the zoning regulations
Total Due$
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES ( )Cash ( )Check#
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 THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY
THE RULES_ IO FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Print Name Date: 11 aIj
Engineering er its/Street Ex ation Permit 2017
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The material contained on this map Title:
sholl be considered proprietary to
Eversource Energy and user(which is '
defined as any person or entity R{/�►who has reserved the mop through EVERS_U■\VE
sale, purchase,exchange,gilt,or assumes
shown s not guaranteed and Eversource Energy _
andshall shall keep o in confidence -assumes no responsibility. Contractors mati are urged to call ENERGY
and shall not furnish or disclose it Eversource Energy for further information of 1-800-889-0900
to any third party without the prior _
written permission of Eversouce Energy. Plotted:03—Nov-2017 I By:gisewrt