HomeMy WebLinkAboutStreet Cut Permits 350 Chapel Road 1700199 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 09/14/2017
GIS ID: 18000350 FEE: 50.00
MUNIS APPLICATION# 201701234
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EXPIRATION DATE:
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APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS '330`CPfAPEL ROAD
ADDRESS: 112 PROSPECT HI.LD 4 OWNER s RORIUE TIMOTHY TRUSTEE
EAST WINDSOR, CtdYg8$ E 30 CHAPEL ROAD
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x 1'H WINDSOR,CT 06074
PHONE
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WORK DESCRIPTION: INSI1 AST3RVCTQi,EW CO�I9TItCfO%'WORKING FROM 8'
cLRIBETI goRITOSIDFg�?E$LTIEDIII`r x z
APPLICANT AGREES TO FURNISH THCUT0 1�F OTJ`Iz I W1NDSf?R`tl Er.4M�Qi IT�O>i$bND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR Af XPENSE,S fiiCURREI $Y{I CIE TOWIOI;MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE �PILIbA I �AMII IAR W1TI ,4ND�V�!kI L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN Z] SOE nH WINDSbR.'.:S STR),E7 CUT PIIMIT MANUAL.
ISSUED BY Df1'TE- S=PCTED INSPECTED BY
9/14/20172:27PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: �lE
LOCATION: s 3,'-C>
TYPE OF WORK: l a, �3er vie.e if mw cz n i, �e
DATE INSP NEEDED: DATE INSP:
INSPECTED BY -5Z�
WORK IN
PROGRESS:- -
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor iNPSEi:aON 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 $50.00
Name of Firm a Phone No. 9b a"
(�a
Address of Firm D I I 01WH Zip Code 009T
Location of proposed work
Describe fully nature of permit requested V y� Q ice Jul EZ4f ,
it s h� V 1 t� `S 1� `
Starting Ca efore You Dig No 93Cp0 &
(oD a l I y�+ C h
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES,IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: P-Ko Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Puhlie Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price$ /ft
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Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ Isf
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
DRIVEWAYS must be 3ft or more from the property line per Total Due$
section 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 ST T PERMIT MANUAL.
Signed: Print Name Ct�l� W 6 I Date: I�
Engineering/p rmi /Str t Excavation Permit:2017
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he material contained on this map Title:
,hall he considered proprietary to -
.versource Energy and user(which is
;ale, d rc any person e,gift,
g - E Y ERSABURCE
iho has received the ma through Information shown is not guaranteed and Eversource Energy:ale,purchase,exchange,gift, or 9 9Y
nd shall shall keep o in confidence assumes no responsibility. Contractors mati Ore urged to call ENERGY
ind shall not furnish or disclose it Eversource Energy for further information at 1-800-989-0900
0 any third party without the prior
mitten permission of Eversouce Energy, Plotted:30-Au9-2017 By:9i—ri