HomeMy WebLinkAboutStreet Cut Permits 3 Paper Chase 1700075 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 04/28/2017
GIS ID:69000003 j r FEE: 0.00
MUNIS APPLICATION# 201700434 1 EXPIRATION DATE:
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APPLICANT ' GV, LOCATION
NAME: EVERSOURCE A1)bRES4rP CHASE
ADDRESS: 112 PROSPECT HII I�I �pA F r fi OWNERf ICAO RIGHOTHAMA MADHUSUDANA&
EAST WINDSOR,
",,r 3 PzPE CHASE
PHONE SOUTHVINDSOR,CT 06074
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, Z zS' PWORK DESCRIPTION: INSA PS �TION f r5
AT EI �QF GASTAIN -2'X2'VAC HOLE
APPLICANT AGREES TO FURNISH" TOf OFOLF`T � I1�I) I 'AM([JL�7TVOF BIND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A1`1Y�F�XPNSESINC>ID TOTE T WTI �5I2;1ViAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T` E API'I CANT z �kAMT WIIAND�WII�;T.ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN O ( UTH 1> IIa1DSOR'S SxREI"T CUT ' It1VIIT MANUAL.
ISSUED BY INSPECTED BY
4/28/20171I:28AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: 1 "i Q,®0'�S CONTRACTOR: Z V e
LOCATION: 3 C b(
TYPE OF WORK: + X a' V-4e- �L l e-
DATE INSP NEEDED: DATE INSP: 6 LL-
INSPECTED
WORK IN
PROGRESS;_...
SEPTIC TANK.PUMPED;SMASH90,FILLED WITNESSED ❑YES ❑NO
ArBUILT: `
INPUT: �- DATE: n _�
S/molloy/fbrms 2i m Town of Soup Windsor ira CROwwPOU 14
~. PPL1 741'k'Of�fQR VT E "fi UM`M'A n*!,;
App€.No. TOWN OF SOUTH WINDSOR Permit No. '
PUBLIC WORKS DEPARTMENT
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SOUTH WINDSOR,CI..f Q74. :A
FEE:$25Q0
Name of t~ffrxt.. "'"
Address 1411,
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Phone hlb
Location of proposed tarot
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Describe fully nature of P01, t l IE
start!rig ! Approx.trine for'ocaDipli
Call Before You Dig No.,Ivwz�j` w.' ; . Existing:Water Supply: ❑ Pubiic• ❑Well
Existing Sewage Service ❑Public Sewer ❑Septic
hlla'CR: TS'1iPf31 lR'THE PEM� ANENTRAVEMENT PATCH AND CURB REPLACEII€tENF i$A.
1MFAR'Y' 9TIIIII�►'T`IE;.;TRApPL�C�kN FiPQiNSIBLE FOR THE-PULL FINAL COST OF THE
tEIMA�r Pp' CH ANDr+j#t� R>=tA »MENT,IIGiLtJP1P�t�:��!`Y" INCREASES IN PATCH•AR until
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.,IGtYt~t�' iA1FICw1�TJOL (A" 1iR 1`011liil+l`S iDON'I'ilTt0i333. THE Ai�RMANENT P17E#;�R'Typ
�CALLY,.
Il r t'Efl�Ikl'17'HiN t4►IR +€ O fiJ B 'EMPO i'I�F�A'M'OH gUT IT COULD BE LATER THAN A YEAR.
' S t�sib ofprtpbsed t _ ,
1-,0 copies of separate drawing '+
Indicate NorthI Am
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ND
I .Outs:.:.
Est•Patch Siz (sj: 4
Est.Pvt.Thickness
{ s Est.Patch Unit Price$ /s!
(:Est Patch Cost$.
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Est:Curb Replacement. i
,Est.Curb:,MNI.Price:;:$. It Est. i
•:Est Curb.Cost.,
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Est.Traffic Unit Cost$
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Est.Traffic Control
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A of Depos[t
Total Due$'
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Applicant is responsible,foro'p
Paid
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I AGREE TO FURNISH TO THE TOWN OF SOUTHWINDSOR THE AMOUNT OF BOND REQUIRED:AND TO REIMBURSE TIE
TOWN OF SOUTH WINDSOR.FOR ANY EXPENSES'INCURRED BY THE TOWN:FOR MAINTENANCE OR REPAIR WORK !N
CONNECTION WITH THIS PERMIT AND THAT_,I AM FAMILIAR WITH AND WILL ASIDE BY THE RULES AND REGULATIONS FOR
�PERNNTSTOWN'OF,S •,:•,•,WtNDSOR'S STREET CUT PERMIT'M IANUAt..
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Dri1 /ver's L€cense* � �.
P 1~A101 "1'i1'Llif�ll3i`'ltAfa1N01�1i1N��c�($A I±t APPLICATION FOR ISSUANCE OF PERMIT
W. RK MAY Nq. BN"B1N Ulf# A;PEF�Ii��T >EitEtE+l 1t18UED
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Street Excavation Permit 08 REV 10-22-08
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The.mnteba3 rcntolned Qrrthis map :��ti "
staQA de sscTeta�}zta fo SN `
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ENERGY
X �_ N InParmobal sh0+m s no!guornnteed wd 41ee ...Energy essumes no rssponsbdlY'
98Dow! .. I
Nntr� Contractors are urged io.eell Eversauree, tar further fn(omwtion of 1-800—