HomeMy WebLinkAboutStreet Cut Permits 45 Rockledge Drive 1600110 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/23/2016
GIS ID: 76800045 FEE: 25.00
MINIS APPLICATION# 201600854
EXPIRATION DATE: 06/23/2017
APPLICANT s Sri
`I& LOCATION
NAME: AIROLDI'S INC. x ADDRESS '451R0` KLEDGE DRIVE
ADDRESS: P O BOX 71 n QWNER }IyIpRA1V0 ROBERT S&KATHRYN
SOUTH WINDSOR,�CT Its 45 1OCKI EDGE DRIVE
IIWINDSOR,CT 06074
PHONE
WORK DESCRIPTION: D IR VE,wAY 4
4 L • 4 x tfik fT '�.
APPLICANT AGREES TO FURNISH TH �TOVL� T QF 50i7ITL WTNDSpR TFE 1�MpNl�rpFND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR T I;XPEI5I�SES IIS' t; I gy THET01 TBNANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TI3.E APl? I IS FAN I'TAR W TFI AMID W:t ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN O) �(?IJTH WINDSOR S STREET BUT PERMIT MANUAL.
ISSUED BY DATE`1NSPECTED INSPE TED BY
6/23/2016 11:05 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
p ;
PERMIT NO:: CONTRACTOR: A-
LOCATION: 4�1 s
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: t�
WORK IN
PROGRESS: . _, � �. •�� �.� .. ��x� -
SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS—BUILT:
INPUT: DATE:_.
S/molloy/forms 2014 Town of South Windsor INPSEC RON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appi, No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No,
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $26.00
Name of Firm • s -^' Phone No.
Address of Firm �- `1 So���,�'.N�s4� Zip Code O Lz)l
Location of proposed work 4S
Describe fully nature of permit requested
Starting date �' :5; 1 Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut ❑ Pavement Out ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt,Thickness in.
Est. Patch Unit Price$�
Est. Patch Cost$
Est. Curb Replacement ft
Est. Curb Unit Price$ /ft
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
WINDS ET CUT PERMIT MANUAL.
V J Date: 6a 1 b
Signed; Print Name4
Street Excavation Permit 2014