HomeMy WebLinkAboutStreet Cut Permits 9999 Tudor Hill Road 1900043 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
41
DATV.: 05/03/2019 rf
GIS ID:90309999 FEE; 50.00
MUNIS APPLICATION# 201900832 - `EXPIRATION DATE: 05/02/2020
APPLICANT 1 x't -, LOCATION
NAME: EVERSOURCE ti+# N ADDRI~ 9991UDOR HILL ROAD
ADDRESS: 112 PROSPECT HILT;ROAp OWNER n SOrUTI1 WINDSOR TOWN OF
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140 ST�LIVAN AVE
EAST WINDSOR,C�fi06088 r I y
PHONE ;` L
WORK DESCRIPTION: EXAUATATb 1NTAT�L GASv1.4IX+IxAN�S�EIVTCE
APPLICANT AGREES TO FURNISH THE VVN OF SOUTI WINDSORTFIE AMOL11V10 BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXI'Tal*1SES IIC[JRRED.BX TIE TOWN FORMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AI''I ICANT IS FAMIAR W1 H AID11 L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN` ,S AtJTI3 W1IVDSOR'.:S"STIT. UT IT MANUAL.
ISSUED BY DA'TE`'TNSPECTED INSPECTED BY
S 20192:33PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWS OF SOUTH-WINNORINSPECUON DEPART
PERMIT NO.: Q
CONTRACTOR:
LOCATION-63.1
TYPE OF WQRK:
DATE INSP
DATE DISP
NEEDED: :.
INSPECTED.BY: 4 -
WORK.IN �z
PROGRESS:
SHE PILLED 1NTTNESSED ❑YES C] N0
SEPTIC TANK PUMPEDr SMA. : r
AS-BUILT'� . , .
INPUT:
DATE: � d s
SjMojjoyjforms 2014 TGVM of South Windsor MPSWMN REPORT14
t,a a lnraVr\a IVa• ■ Va\ a/ aave—e— I air\V'!-'IV l .. •�.• ""•• �•• •
Appl..No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $50.00
-Fn Phone No. r a—
Name of Firm
Address of Firm 0 4 Zip Code
Location of proposed work bQ
Describe fully nature of permit requested C0 AAAW 4 S C
Starting date Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut avement Cut ❑Curb Cut ❑Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
0 No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
k
Est.Patch Unit Price$ Isf
5� , (w Est. Patch Cost$
l�! Est.Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price$ Isf
Est.Sidewalk Cost
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
i
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
( )Cash ( )Check#
Applicant is responsible for contacting the Police Dept.and C.B.Y.D
PERMIT SHALL BE KEPT ON J013SITE 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 STT PERMIT MANUAL. r�II / }
Signed: t Print Name &U( A - /,`Se �'1 Date: J�
Engineering/p rmi /Straet EXCaVatiOn rarrniL 4v.L f