HomeMy WebLinkAboutStreet Cut Permits 97 Overlook Road 1700232 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 11/07/2017
GIS ID:67500097 FEE: 50.00
MUNIS APPLICATION# 201701594 m ~EXPIRATION DATE: 11/07/2018
APPLICANP � kr
LOCATION
NAME: CENTRAL SEALING;CO IN u ADDRESS ,j� 7 6VLRLOOK ROAD
ADDRESS: 150 SUNSET RIDGETb'i °TB V ; gWNKR GRAWFpRD KEVIN B&EILEEN W
EAST HARTFORD,wCQ6lb$ 5 V W OOK ROAD
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SOU I°H`WWINDSOR,CT 06074
PHONE 860-289-7900 S '
WORK DESCRIPTION: DRIVEWAY�r �4ts i „ate s
APPLICANT AGREES TO FURNISH TH I O N OlI SOU 11 y DSClt-I IE AMOUI P QtiF B(bND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AFiaX: XPENS'ES.IN6'IaIR 1 BY fINIE T(J1�J1�1 FpI2,�vIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THF I BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OI~SOU I I VINDSOI ',.S S REET CIJT PEttMIT MANUAL.
ISSUED BY DA INS ECTED INSPECTED BY
11/7/201710:12AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO,: r1 D CONTRACTOR: 1 -Seal
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: y /S
INSPECTED BY: 130
WORK IN /
PROGRESS: v
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT: '
INPUT:- ,tN`- - DATE:
S/molloy/forms 2014 Town of South Windsor INPSECrION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
App€. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 006074 _ FEE $25.00
Name of Firm (levJ 1 S'eM 1 " (v I IU-C. Phone No. %6 `,0 '7 I b 1
Address of Firm S1) 'at lq .p ( ZJET I VL"' 1 S Zip Code [�
Location of proposed work clrl 0 v-e k- 12 } J
Describe fully nature of permit requested ' r �' 1 1 Qt.- C
)
Starting date I L) i Call Before You Dig No �L� L'
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT 1S A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: 0 No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
Est.Patch Size(s) sf
00 Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost$
i Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
3 l2-0 Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
Applicant is responsible for contacting the Police Dept.and C.B.Y.D ( )Cash OCheck#
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 CUT ORMIT MANUAL. 1
Signed: Q2:AA� Print Name j'u-[LQ- T_,1!l( ZZ� Date: i) 117
Street Excavati Permit 2014