HomeMy WebLinkAboutStreet Cut Permits 9999 Rye Street (2) 1500209 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
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DATE: 09/14/2015
GIS ID: 78609999 Si»s ; 1 z 14 oh,
MUNISAPPLICATION# 201501261b z � h 3 FEE: 0.00
� 31° c �R PIRATION DATE:
APPLICA
NAME: EVERSOURCE LOCATION
ADDRESS: 112 PROSPECT HILfiRIrhl �� � 5� {ri ADDRI S ,` vgA91xE STREET AT TROY ROAD
EAST WINDSOR, ;` 8 �t� SO4�NI?R y ?TOWN`�F SOUTH WINDSOR
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1I1kSULLIVANAVE
INDSOR,CT 06074
PHONE 860-292-2242 ja' �, TF �ry y S� f HV
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WORK DESCRIPTION: `
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APPLICANT AGREES TO FURNISH TH 0�1�0 OU 4 S f
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THE TOWN OF SOUTH WINDSOR IN
ND REQUIRED AND TO REIMBURSE FOR AN�YiCE�ETsT,S$S�I1U i �
CONNECTION WITH THIS PERMIT AND TI ��CA �,IAIr DL�.A IDE RUNANCE OR LES AND REPAIR GULATIONS
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FOR PERMITS AS OUTLINED IN THE TOWNIFQT�Y BIND SO`g'S ST &IZ VIIT MANUAL.
ISSUED
DATE SPE TED INSPECTED BY
9/14/201512:13PM *** PERMIT TO 13E KEPT.ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO-4 15-oo,�2o 9 CONTRACTOR:
LOCATION:_ 99 t 9 dye sL_rfe-L -Y0 �.i koa
TYPE OF WORK: 7 -5
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DATE INSP NEEDED: DATE INSP: I l L2_
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INSPECTED BY: �t
WORK IN
PROGRES
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE. III - 1 ,
S/molloy/fiorms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICA'hON-FOI!FSTREE7`fXOA-V7��'I tpPtggl"�
Appl.No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
-� SOUTH WINDSOR,C-T-DA074. . —
FEE $25.00
Name of Firm w(b ura &)ervq Phone
Address of Firm /Z C ) Zip Code—s�
Location of proposed work (� �,�.
Describe fully natureof permit requested tii L
Starting date Approx.time for completion .7 d a
Call Before You Dig No. Existing Water Supply: ❑ Public Water ❑Well
Existing Sewage Service: ❑Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY.PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filied out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts
Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Est.Patch Cost-$-
Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Traffic Unit Cost$ - /hr
Est.Traffic Control$
5�
Amt.of Deposit$
Total Due$
O Cash ( )Check#
Applicant is responsible for contacting Paid By
the Police Dept.and C.B.Y.D,
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 OUTLINED THE TOWN O`FSUUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed Date:_- _�
Title: C'��c oStcrn t{� ? Driver's License#: 2 /
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08 REV 10-22-08
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wrirten permission of Eversouroe Energy. Contraotore are urged to toll Everaouroe Energy for further rtformoGan at t-800-989-nB00 Dote. — ep-
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Eversource Energy and user(which is
defined as any person or entity (� i
who has recewed the map through -W s i`sale,purchase, exchange,gift orJLf
otherwise)sheil keep it in confidence
and shall not furnish or disclose it
:a any third pony without the prior information sheen is not guaranteed and Evermun:e Energy assumes no,aspon�ubir,M�
written permission of Eversource Energy. Controelam ore urged to tail Evereource Energy for further Information at 7800M—Olw a e: — ep—
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