HomeMy WebLinkAboutStreet Cut Permits 9999 Graham Road 1700196 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/08/2017
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GIS ID:37509999 }\` ,^ FEE: 50.00
MUNIS APPLICATION# 201701213 `EXPIRATION DATE: 09/08/2018
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APPLICANT r'' 3 LOCATION
NAME: SIMSCROFT ECHO �i RMSL` ADDRESS 4GRAHM ROAD
ADDRESS: P O BOX 581 yr z t) N1sR OWN F SOUTH WINDSOR
SIMSBURY,CT 060.<0 sl 1540"SULLIVAN AVE
t: 4- UTHU✓INDSOR,CT 06074
PHONE 860-65I-0231 w
WORK DESCRIPTION: ST�W� E�RORARIIILI�skA ?THE ESTATES AT
SOU ISII*ID4�RTOI�,BIZO�HERS <F ;z s l
APPLICANT AGREES TO FURNISH TH> !O Ok SOUH WID�SI� H :?NIQUl1T QI BAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FORAY PIafiISES Ii�TGL1RI�FD �fiHE Tb 5FOW MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T A���LI_C`ANT'IS A1V�ILIAR WITH - 1�11I L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SbiJ I I WIIrTDSO-'S STREET, T P RIVIIT MANUAL.
ISSUED BY DA 'E INSPECTED INSPECTED BY
9/8/2017 11:0 SAM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.. 1700�;f CONTRACTOR:�'r
LOCATION.. 9 ,l q �� e�
TYPE WORK:OF W
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DATE INSP NEEDED: DATE INSP: IL17115
INSPECTED BY:
WORK IN
PROGRESS:
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: Gam' DATE:
S/moiloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl, No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $50.00
Name of Firm Q� j�7� F L c_; Phone No. (r��c) t - y,Z 3
Address of Firm GiJ Zip Code c;c `To
Location of proposed work' . +--r=hU-
Describe fully nature of permit requested
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Starting date Calf Before You Dig No-2Q/ 1 3 Z<) 1i ,Z 12-
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'$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: [I No Pavement,Curb or Sidewalk Cut L9'Pavement Cut 13 Curb Cut ❑Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening C 1Proposed 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
ro
Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est.Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price$ Ift
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$
DRIVEWAYS must be 3ft or more from the property line per Total Due$
section 2.17 of the zoning regulations
OCash OCheck#
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
WINDSOR'$8T T T PERMIT MAN L. '
Signed: ti�ti� Print Name �P I Y�� Date:
Engineerin /permits/Street Excavation Permit 2017
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