HomeMy WebLinkAboutStreet Cut Permits 91 Bourbon Street 1700053 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/24/2017
GIS ID: 12300091 FEE:
0.00
MUNIS APPLICATION# 201700267 `PXPIRATION DATE:
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APPLICANT`
NAME: EVERSOURCE x5 LOCATION
ADDRESS ,91 OWON STREET
ADDRESS: 112 PROSPECT HILL,IOAp u OWNER EZZEDINE DIALA
EAST WINDSOR,CT 001"888 9I T#�URBON STREET
s "' SOUTH"DSOR,CT 06074
PHONE
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WORK DESCRIPTION: GAS S1RIE UORIIItTG FR(aNI AiGQgS SET C?LLHOUSE NO
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APPLICANT AGREES TO FURNISH THE TOWN OI $OUT>I I I�SOR HE Wdq 0 O$#WD REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AI41Y` NRE14 F.S INC "AREID fl% THE TQ.W11TrF 1VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THiS PERMIT AND THE AI4PI iCANT IS FAI�IILIAR WITH.t�"IT' I[L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S.
WINDS R' S REET CUT P_ IT MANUAL.
ISSUED BY DACE INSPECTED INSPECTED BY
3/24/2017 1:18 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOHTH WINDSOR INSPECTIQN REPORT
PERMIT NO:. 7xa. R CONTRACTOR;✓
LOCATION. C-� ►�
TYPE OF WORK: L-S S-aAAJ CIO
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DATE INSP NEEDED: DATE INSP. .
INSPECTED BY. b
WORK IN
PROGRESS: G'sk � °<_ S�lr��v'� ��✓ ,�t�.... 'r`,`
• SEPTIC TANK.PUMPED;SMASHED,FILLED WITNESSED ❑YES ❑NO
AS-BUILT;
INPUT: DATE: -�
S/movay/bmms2emTawn of South WindsorlommTIC WNPORT14
APPLICATION FOR STREET EXCAVATION PERMIT
Appt:No, TOWN OF'SO:UTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00
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Name of IritFt `
Address of Fikl> ... P.::....::.....::.:.... .. ..:..::...'.`..:...::
:Location:afi ro osed : -
Describe fully nature of permit requested_ ' U k >: �O 1 1�l9- -I'^� - ... C —=
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Starting date '" "" ` -. .Call Before You Dig
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PLEASE NOTE: THE DEPOSIT'FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACE.MENT`IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC'CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed.Driveway Widening ❑ Proposed New Driveway
Water Supply; CI Public Water ❑ Well Sewage Service: 13 Public:Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North Thiia��iae n�ta ite tilledtllC '� yy�� �'f
two copies of separate.drawing
No.cuts
Est. Patch Size(s) sf
11
i Est.Pvt.Thickness in.
Est.Patch Unit Price°.$ ...... ..... ;s'
1 Est.Patch Cost$
Est.Curb Replacement it
Est.Curb Unit Price$. fit
Est.Curb Gbst$. .:,. ...:::..:..._: _:.........:..: —_.
Est.Sidewalk Replacement sf
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Est.Sidewalk Unit`Price`f. /sf
Est.Sidewalk Cost'
Est.Traffic Hours (ti`
Est.Traffic Unit Cost
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Est.Traffic Control < .
Amt.of Deposit$::.. . ...
DRIVEWAYS must be'3ft or more from the property line per TotsI Due;..,•.:: ..:.:.:.:..::.:'::':.:.::... .._...::..-...._ ............-:. :a
section 2.11 of.the zoning regulations
O Cash ( )Check*.,.,.-.
Applicant is responsible for,cent dting the Police Dept.and C.B.Y.D
PERMIT SI ALL BE KEPT ON JOBSITE AT ALL TIMES Paid 6y
.I AGREE TO FURNISH TO THE TOWWOF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH
WINDSOR.FOR ANY EXPENSES(NOURRED B`(THE TOWN FOR MAINTENANCE OR.REPAIR.WORK IN CONNECTION WITH THIS PERMIT AND
THAT I AM FAMILIAR WITH AND WILLL ABIDE BY THE:RULES AND REGULATIONS FOR PERMITS:AS::OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S STREET CUT PERMIT MANUAL.
Signed* Print Nglttte .+ :� �sl ` i�1 ..... ...
Date:
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Street Enavatlon Perm' 2014.
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