HomeMy WebLinkAboutStreet Cut Permits 68 Bourbon Street 1700017 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/06/2017 {
GIS ID: 12300068 �.r FEE: 0.00
MUNIS APPLICATION# 201700186 ,+ x,
tXPIRATION DATE:
APPLICANT` k° fi' LOCATION
NAME: EVERSOURCE �' `
AI3DRE �68y1#pI�RBON STREET
ADDRESS: 112 PROSPECT HILI#, dAl Y v y j O !ENEIZw TEAR IVIELVIN C&
EAST WINDSOR,CTS � 08$ IC)U�tBON STREET
PHONE i `zY t ' �` t?UTH. INDSOR,CT 06074
WORK DESCRIPTION: GA �SRV10R1G'r1* 0, I�1DT,I �CLyILgkL1NE TO HOUSE
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APPLICANT AGREES TO FURNISH TH OVI; POUT3k �S�3RHE AMQCIITi01f BdND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR APENSES 1IC R1.EI_BY I TlW1?� CAN MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TFAPPIICANT:IS�l` a ^4 FAMIL'IARTI� yDTI L ABIDE.BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN( SOUTH WINDSC? 51�TR &�CUT 1� RMIT MANUAL.
ISSUED BY DA'I;E INSPECTED INSPECTED BY
3/6/20I72:38PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT M: 1.7 CONTRACTOR:_ l ko Cl.
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: s" 1
INSPECTED BY:
WORK IN
PROGRESS;
SEPTIC TANK.PUMPED;SMASHED, FILLED WITNESSED ❑YES ❑NO
AS-BUILT: � • .
DATE:
S/molloy/forms 2014 Town of Soo Wndwr INPSE=WREPORT 14 "'
APPLICATION FOR:STREET EXCAVATION PERMIT
Appl. No; TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No,
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDS.O,R.CT 06074 FEE $25 00
Name of Fit Phone.No 6 — 2 2" 2.Z5 B
Addeess of Etftt3` #►�b a ro # ;` •.Code
...:
Location of proposed wor1� c ..
t smreqe A.yDescribe fully nature of p r
1�. hitC :
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Starting date .. "� Gall Before You Dig No � (')
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT ISI RESPONSIBLE FOR THE FULL FINAL.COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY.
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND.THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY'PATCH BUT IT COULD RELATER THAN A YEAR.
Check, Applicable: 1 ;'No Pavement;Curb:or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway;No Changes ❑ Proposed Driveway.Widening ❑ Proposed New Driveway
Water Supply: 0 Public Water CI fNelI Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North Ihfis tbtdatAlff,
two copies of separate drawing
No::outs,......:......:.... ............ ........... ._.
.......:..........
Est. Patch Size(&
Est.Pvt.Thickness in..
............... 9
...........
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Est.Patch Unit'Price
Est.Patch Cost '
i
Est.Curb Replacement it
Est..Curb Unit Price$;
Est.Curb Cost . .
Est.Sidewalk Replacement sf ,
i
Est.Sidewalk Unit Price$ /sf
r. Est.Sidewalk.Cost.$.:
:Est.Traffic Hours:..:........::.::....::....
:..__. .::::::::
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Est.Traffic Unit:Cost$ /hr
i
Est.Traffic Control$
i Amt.of.Deposlt$
DRINEWAYS.muet be aft or more. from the property line per Total Due;6
section 217 of the zoning regulations.
( ) Cash ( )Check#.. ..T`� s
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 REQUIRE..ANC?TO'REIMBURSE THE TOWN 4F SOUTH'
WINDSOR FOR ANY EXPENSES INC.:.URRED:BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN IIUITH THIS PERM AND.
THAT I AM FAMILIAR WITH.AND WILL AS BY'THE'RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH'
WINDSOR`S STREET CUT`'PERMIT MANUAL::
t I�l -ic Date:
^
'aY° ads Print Name::,
Street Excavatlon..Perrrsil:2014 :
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