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HomeMy WebLinkAboutStreet Cut Permits 37 Evergreen Lane 1600016 TOWN OF SOUTH WINDSOR,_ CT PERMIT NUMBER STREET CUT PERMIT DATE: 03/17/2016 GIS ID:31200037 FEE: 25.00 MUNIS APPLICATION# 201600255 f E . r n��, XPIRATION DATE: 03/17/20I7 APPLICANR LOCATION NAME: TELE-NETWORKS37VRGREEN LANE ADDRESS: 31 BAKEWELL COL�'R�TµY ' l�AEI3BALVANTBHAI R& x ,? YY 1V CRASTON,RI 0292�' rl~VIZGREEN LANE w Y SJU{1H WINDSOR,CT 06074 PHONE 401-461-8420 WORK DESCRIPTION: REFI, GE`IyISx1N ATV z y � APPLICANT AGREES TO FURNISH THI?� OyG�N`QF SOUTH�`WXI' A19 HE AM OF BAND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR IS 3fPENsI S I1kIC�TRI�I;I�HS 11 TpW1�tiFQRsMAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND T API',LI ANTI 'N iPLIAR�JT�I AND�V�IT L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TO WN OF SOrtJTH 1ri�1iVDS�%':;S RT11 E`T CUT'PE 2MIT MANUAL. ISST BY DATE`°INSPECTED INSPECTED BY 3/17120I69:56AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** --------"-- -- -------------------'---------- ol N N O ` of as�gS d��y 44 r `Ft x: 1 a � � i t• Si s th yS } :A.E TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: I��� CONTRACTOR:_ LOCATION: S 7 4',,�,zA za luz TYPE OF WORK: g 6,0 DATE INSP NEEDED' DATE INSP: INSPECTED BY: L WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO AS-BUILT: INPUT: DATE: S/moRoyftbrms 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 $25.00 Name of Firm 7e' le-N"4-wv rk S Phone No. Address of Firm I Go-kec,, ll C-- Cron -to A I'. _ Zip Code a �' Location of proposed work '3 7 b v6 rgneeaL� Describe fully nature of permit requested 8ew2k1c.6 ` •h' C TV Starting date ?'+18 Call Before You Dig No 0 6 IGo 3s9c, PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Check Applicable: Vt No Pavement,Curb or Sidewalk Cut O Pavement Cut ❑ Curb Cut ❑ Sidewalk Out © Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic Show sketch of proposed work or furnish Indicate North This section to be filled out by Town two copies of separate drawing No.cuts S 2 e .�-kxc;iet� 0 Est. Patch Size(s) sf Est. Pvt.Thickness in. Est. Patch Unit Price Est.Patch Cost$ Est. Curb Replacement It Est.Curb Unit Price Est.Curb Cost$ Est.Sidewalk Replacement sf Est.Sidewalk Unit Price$ /sf 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 WINDSOR'S STREET CC PERMIT MANUAL. �yy �+ l� Signe l�� V �"`J Print Name RIM f ( Date: I Stre t Excavati n Permit 2014 y vt rA r 26 ❑ X File _ Edit Billing Semites Customer Information Order Entry PPV Financial History HSD Help IT • Acct Nbr 4i7 ?-45 Task BALI,r1tIBH.I FATEL Co0;,-'Frn 51 10 426 CLISt Info i ' • 37 Eve_g_een Ln Phone'": Home 8-E0 416-1c-12 View 2 3--uth N.4ndsc_, CI OE074-3540 Bus Tech# 0 lit— Q Code Q BURY Job Seq ,,'Exit and Retain i Priority 5 Pool j Job Nbr nnp Tag Nbr 457175 Menu Pts Work Order plumber 20500016 Problem Code Svcs Work Order Type SR sFeci.al Requeaz Addtl Problem Codes Stage History Work Order Status ttct Ccded Primary Finding . Dispatch Comment Primary SOILItiOrlSlots - Prorates. Work Order Comments 75-100FI 3I2E!QJ-; BORE PAC' TEuF Pri Loc Sti3 Sch Date 5/15/16 Sec Loc jech Flash Sch Time I,LL_YI Node lD 3 N It Comments Ckin Usr Stage Cat Occ Service Frorn To AmountPnts Emp User ID C 1 t1UGOR0P U= DROPS-7 1 C G JAITOR::vn i- i Ic ON/ CUMMUNICAJIU +I( (k, J''lJ FR- 53"�12te, �r5� ���My�1, a�- 3 - 6