HomeMy WebLinkAboutStreet Cut Permits 38 Shag Bark Road 1700091 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/22/2017
GIS ID: 82200038 / F FEE: 25.00
MUNIS APPLICATION# 201700584AV
", XPIRATION DATE: 05/22/2018
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APPLICANT
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NAME: CENTRAL SEALING' G BARK ROAD
ADDRESS: 150 SUNSET RIDGEi � OWNER k OEN&G IDA C
EAST HARTFORD,,�TI3fi08 w t= 3�8IA BARK RD
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WORK DESCRIPTION: DRIVEWAY 4 y �'�r�' uh�✓ �{ ��.
APPLICANT AGREES TO FURNISH TH&TOWN bF SOUT I W3NpS{R 3 HR M�}U T€0 B., ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR 4Y; P)JIESUlit ;$ TIIE T 010R, I.4INTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TEE AFi ICON I ZrFAllIIIcIAR WITH DSW L ABIDE.BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN:W$00VI WINDSCII 'S STREET CLOT P1aR 1IT MANUAL.
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ISSUED B llE1TE INSPECTED INSPECTED BY
5/22/2017I0,17AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOuTH IARNDS4R INSPEG"fIQN REPORT
PERMIT lv0:: CONTRAC MR Pam' I 5611;-Oa tZ
LOCATION: 3.9 _
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: // -'f
INS.PECMD Eli(: 10
WORK IN
PROGREs;
SEPTIC TANK.PUMPED,SMASH90,FILLED WITNESSED ❑YES ❑NO
INPUT: DATE ,.
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APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL. 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 006074 - FEE $25.00
Name of Firm � �lq fy ml -sellII M 0D I VA& - hone No.
Address of Firm I ' ° tt VL V f`' ✓e 0,EZip Code QrPj 1
Location of proposed work
Describe fully nature of permit requested i'� 5 (z-�. ❑✓e S
Starting date a
Call Before You Dig
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR,
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Out ❑ Sidewalk Cut
fyExisting Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be tilled out by Town
two copies of separate drawing No.cuts
0 Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
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Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ Isf
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Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
f2� 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 C �PERMIT MANUAL. _
Signed: Name
Street Excavati Permit 2014