HomeMy WebLinkAboutStreet Cut Permits 29 Bourbon Street 1700022 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/07/2017
GIS ID: 12309999 FEE: 0.00
MUNIS APPLICATION# 201700197 _ r k EXPIRATION DATE:
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APPLICANT
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NAME: EVERSOURCE tis r £ ADDRESS �2BOTRBON STREET
ADDRESS: 112 PROSPECT HILL;Ra ,D � VI�TER TOWN }F SOUTH WINDSOR
EAST WINDSOR, CT 0608t y MUM, AVE
CT 060742734
PHONE ,i
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WORK DESCRIPTION: GAS S RVx I�WORi INGF1 QNf A I OS T�I STRE T ON FOSTER ST EXT
APPLICANT AGREES TO FURNISH THE TOWI`i F'SOI7TH Wt1NDSC I ' HE`A1VI 3LW7 IF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN1�' 7 PE11TSES I1�iCU1 ItEpam T IE TOWN Fbh141AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIDE LES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN CF SOIITH WIIDSOlt STREETLT�1'EI2MIT MANUAL,
77140 I)D
ISSUED BY DA E ITS� CTEDSp
ECTED BY
3I7/20173:07PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 17000 CONTRACTOR: r 4-
LOCATION: 9 b2tt—eer
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED
WORK IN
PROGRESS: z.=/1-, S'z-r v
SEPTIC TANK PUMPED;SMASH9D,FILLED WITNESSED ❑YES ❑NO
AS-BUILT: �•
INPUT.-- DATE*
S/mawy/Irorms 2E1m Town of South Windsor mpsemOWWOU 14
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APPLICATION FOR STREET EXCAVATION PERMIT
Appl.,No. TOWN OF SOUTH WINDSOR PUBLIC WORKS.DEPARTMENT Permit No.
TOWN::HALL 154.0 SULLIVAN AVENUE SOUTH WINDSOR.,CT 06074 FEE $25 00
E Phone N'
Name of >I1t =;.
Address of.�jit 1'.• ' , s c C_: ' Z Code -
Location of proposed work -. ;- - - --
Describe fully natu.re.:of,permit reque
041
Starting do "' ` ''" ' Call Before You Dig Nib .,' - -
PLEASE NOTE::THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY,ESTIMATE. THE
APPLICANT IS RESPONSIBLE"FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PA.C.H AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH:1..5
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN.A YEAR.
Check Applicable: d No P,avern M Curb or Sidewalk Cut. ❑ Pavement Cut ❑ Curb Gut ❑ Sidewalk Cut
❑ :Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply:' ❑ Public Water ❑ Well Sewage:Serv.ice: ❑ Public:;Se.Wet ❑ ;Sep21c' ti
Show sketch of proposed work or furnish Indicate North This>s'ectfosr`s�tl�efller#aut`>ksv Totrtt+,, '`
two copies of Separate drawing
i No.cuts.:......... .....
I a Est. Patch Sizes) sf
Est,Pvt.Thickness in.
Est.Patch Unit Price$:. !s
i � 3 Est.Patch Cost
i ! 'Est.Curb Replacement ft '
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Est.Curb'Unit Price$ /ft
�s
' E Est.Curb Cost;.$.:
i' Est.Sidewalk Replacement' sf
Est.Sidewalk Unit Price$ /sf
E�€
1`€ Est.Sidewalk Cost;.
Est.T.,raffic Hours
Est.:Traffic Unit Cost$ Jhr
Y Est.Traffic Control$::::..
Amt.of Deposit
...............:..:......:.—...:..
•:.DRIVEWAYS must be'3ft or more from the property line per Total Due`$ -
sec to 2:17 of the zoning regulations
{ )Cash! { )Check#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
PERMIT SHALL BE KEPT ON 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 STREET CUT PERMIT MANUAL.
SI 9ned= :..• Print Name. t Date:
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Street Excavation Permit 2014
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2 X HP 1984
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