HomeMy WebLinkAboutStreet Cut Permits 35 Shag Bark Road 1700145 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/11/2017
GIS ID: 82200035 FEE: 25.00
MUNIS APPLICATION# 201700890sk EXPIRATION DATE: 07/11/2018
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NAME: CENTRAL SEALINq?o IN,� r ADDRESS 3 SHS G BARK ROAD
ADDRESS: 150 SUNSET RIDGHDRIVE QWNE t JENNI GS ARTHUR J&JUSTINE C
EAST HARTFORD SG "46 1�08 3 SAG BARK RD
PHONE 860-289-7900 ti
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WORK DESCRIPTION: DRT�vU'AIr - �.t ' n
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APPLICANT AGREES TO FURNISH TH1 aTOVV�I Fj SOUS H I DSl7R` HE'AMOT1NM OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A�NTYtEXPE1SIv$INC�X2RED> Y'THF TpWN FOR`IvIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T1�E A IS FAI1?IILTAR WITIi AIs1 `WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN O SC7tJ�H W12JD&QR"',S STREFsT CZJT PERMIT MANUAL.
ISSUED BY DATE IhTSPECTED INSPECTED BY
7/11/201710:36AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: V160M._5' CONTRACTOR: ,ea m "�J)'ar'
LOCATION: " d
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TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: (y" DATE: 6
S/molloy/forms 2014 Town of South Windsor INPSEMON 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 $25.00
Name of Firm � ' sezt�l 0o t� Phone No. 'D L � � ��
Address of Firm _ Le- f J' .L��( Zip Code
Location of proposed work 'S 0-� j4 Z{
Describe fully nature of permit requested LC
Starting date Call Before You Dig No is
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PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut D Pavement Cut D Curb Cut D Sidewalk Cut
�isting Driveway, No Changes D Proposed Driveway Widening 173 Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer D Septic
Show sketch of proposed work or furnish Indicate North This section to be tilled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
S Est.Curb Replacement ft
-"G'f4-1 Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ Isf
Est.Sidewalk Cast$
i Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S STREET CU PERMIT MANUAL.
Signed: ' Print Name � �� j t'I `�2 Z' Dater
Street Excavati Permit 2014