HomeMy WebLinkAboutStreet Cut Permits 36 Tumble Brook Drive 1600088 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 06/01/2016
GIS ID: 90600036 "
MLINIS APPLICATION# 2016007I2 �OF 4 tt a � �� FEE: 25.00
# F f EXPIRATION DATE: 06/01/1017
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APPLICA w� 5 r5
NAME: AIROLDI'S INC. "` `�� 7 LOCATION
ADDRESS: P O BOX 71 Q, ' ._fiL2 54 E tDDRS ;3 I U�IBLE BROOK DRIVE
SOUTH WINDS
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WORK DESCRIPTION: DI VRAWN2
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APPLICANT AGREES TO FURNISH TH&TO WN O'.F$OU OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AI4IhECPSIAES I1�3CGCI�D$Sy TOSFIZ MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND 1I4FI+LICANT Ida 1 LIR ( Ii ]��Wx L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THI;T�WN 1 S( J H +7�VDSook sm 81 tT p MIT MANUAL.
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ISSUED BY DAfiE-IiT PECTED INSPECTED BY
6/1/20 1 6 3:55PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: O CONTRACTOR:
LOCATION: (o 61
TYPE OF WORK: ll �
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: iJ
WORK IN
PROGRESS: S
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/molioy/farms 2014 Town of South Windsor TNPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00
Name of Firm ���c n\ l s ;-� . Phone No.
Address of Firm_ a. ��1 ���� v�,b� �� Zip Code
Location of proposed work mom\ v k
Describe fully nature of permit requested
Starting date ��� t L Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL_AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No. cuts
Est. Patch Size(s) sf
\-A I Est. Pvt.Thickness in.
F�o' Est. Patch Unit Price
as Est.Patch Cost$
1 Est.Curb Replacement ft
fi
s Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price
` ( Est.Sidewalk Cost$
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 I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSO T CUT PERMIT MANUAL.
Signed: �— Print Name '\�-' "\"��� ��� ��� Date: 1 1
Street Excavation Permit 2014