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HomeMy WebLinkAboutStreet Cut Permits 733 Governors highway 1700139 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 06/28/2017 GIS ID: 36900733 4 FEE: 25.00 MUNIS APPLICATION# 201700811 EXPIRATION DATE: 06/28/20I8 S.;- APPLICANT 1 ,* % LOCATION NAME: AIROLDI'S INC. " ADDRI;55 �733 Gb. RNORS HIGHWAY ADDRESS: P O BOX 71 �?OBL KERRY M&MICHAEL K SOUTH WINDSOR T O b64}7 z 73 GOVERNORS HWY x� S�DUTHVINDSOR,CT 06074 PHONE 4 � �? t WORK DESCRIPTION: D s £ �AFY APPLICANT AGREES TO FURNISH TII>'ITO NhQF$OCI J WIND3i7R IzHE AMO�II TT QF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AI7PINESLLIiVC�IRRE1? Y'THE FOWi'7 F,OB;IVIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND T1 A ICANT,IS IwAI�ITL t WITH WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TO WNtI?F SQIITH BINDS!} 'S STREETIT MANUAL. SU D BY D '"FE IISPECTED INSPECTED BY 6/28/2017 10:30 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** r f'J 4 14 s x i y ti' 11Y ., Jut 5 V: fn 5 1 TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: . 00 lH CONTRACTOR: zbTola/ LOCATION: - . -r e ) TYPE OF WORK: DATE INSP NEEDED: DATE INSP: A INSPECTED BY: 6 O WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: ' DATE: I J 7"I S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14 APPLICATION FOR STREET EXCAVATION PERMIT Appl. No, TOWN OF SOUTH WINDSOR Pormit No, PUBLIC WORKS DEPARTMENT 1640 SULLIVAN AVENUE Date; SOUTH WINDSOR,CT 06074 ! � � FEE $25.00 ff Name of Firm 11 I ✓'d Phone No, Address of Firm. PO, �0,X ( �<� +� W�'A a Zip Code 07 Location of proposed work 3 5�(m V S �w Describe fully naturo of permit requested j�fii�2W y Q�I�t�c��I.i✓L Starting data y°� (�"Y Approx,time for completion Call Before You Dig No. Existing Water Supply; ❑Public Water ❑Well •2 D 17,2 50 a<c Existing Sewage Service; []Public Sewer El Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE, THE APPI[.'('•ANT IS RFSPOINS-113L E F0,n 7111-:r Cr L rftIAL 0o3T OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR, Show sketch of proposed work or furnish Ibis saottpn to be filled-olitby two oopios of separate drawing Indloate North Town of South Windsor No.cuts Est,Patch Slza(a) sf Est,Pvt.Thickness In, Est,Patch Unit Prioo Est.Patob Cost Est,Curb Replacement ft r Est.Curb Unit Price$ /It Est,curb Cost Est.Traffio Unit Cast$ Est.Trafflo Control$ Anti,©i Dropuslt$ Total Due$ ------' 5 --------� ( )Cash ( )Check N Applicant Is responsible for contacting Paid By a the Pollco Dept.and C.B.Y•D, 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 OONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS UT N I %TOWW1 OF SOUTH WINDSQR'S TREET CUT PE MIT MANUAL, Signed; ,�7ata• tttt (� cy c- L�L� ? � /�1 S� l .a I-� �f� �5��9�7y Drivet'eLlC9nee�; C�� !U l� Title,._ �...,., a PLEASE ALLOW AT LEAST TWO WORKINQ DAYS AFTER APPLICATION POP ISSUANCE OF PERMIT WORK MAY NOT 13EGIN UNTIL A PERMIT HAS BEEN ISSUED PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Street Excavatfon Permit 08 REV 10.72M