HomeMy WebLinkAboutStreet Cut Permits 9999 Tudor Hill Road (2) 3 TOWN OF SOUTH WINDSOR, CT
PEERMITRMIT NUMBEx STREET CUT PUBLIC UTILITY
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DATV,: 05/03/2019
GIS ID: 90309999 kk'
MUNIS APPLICATION# 201900832 FEE: 50.00
EXPIRATION DATE: 05/02/2020
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APPLICANT 3 f x , LOCATION
NAME: EVERSOURCE ADDRESS 9999 T[]DOR HILL ROAD
ADDRESS: 112 PROSPECT HILA k0AD i p
4 WNER s SOUTHt`WINDSORTOWN OF
f 1540;SL7LLIVAN AVE
EAST WINDSOR CAI 060$ i
PHONE14
+ 7 k
WORK DESCRIPTION: EXAATE TO TNSTAIL GAS>11AITI'iAND,t$ IVICE,Fu
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APPLICANT AGREES TO FURNISH TH ,TOWN OF SOUTH W'INDSIjR THIrt AMOUNTOF BAND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AI 1'I;XPEN3E,S.IIVCCJRRED.$Y'THE TOi1UITrvIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TAK APP,L CANT.I5 FAIVIII IAR V M.I A ii� T L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN dF SbU:TH WINDSOIZ.':S STREET CUT T'LRMIT MANUAL,
ISSUED BY DATE`IIVSPECTED INSPECTED BY
5/320192:33PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWS OF SQITN.1NNbSQRINSP�ECnON REPORT
PERMIT NO..
LOCATION.
TYPE OF VIIQRK:
TE INSP NEEDED• DATE INSP � r
DA. .
INSPECTED
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PROGRESS`
SEPTIC TANK PUMPED,SN SHD; FILLED
WMESSED 0-YES El NO.
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Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 nFE� _
E $50.00
Name of Firm n Phone No. �� D t�
Address of Firm 0 Zip Code
Location of proposed work . 82
Describe fully nature of permit requested S W i+J S C
Starting date 579 In Call Before You Dig No Zel134_ 326.�._.._,_
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PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES-IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: 0 No Pavement,Curb or Sidewalk Cut 'avement Cut ❑ Curb Cut ❑Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑Proposed New Driveway
Water Supply: ❑ Public Water ❑Well Sewage Service: ❑ Public Sewer ❑Septic
Show sketch of proposed work or furnish Indicate North This section to be tilled out by Town
two copies of separate drawing
0 No.cuts
Est.Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price$ /sf
5 l Est.Patch Cost$
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Est.Curb Replacement ft
Est.Curb Unit Price$ /fit
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price$ Isf
Est.Sidewalk Cost$
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Est.Traffic Hours hr
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Est.Traffic Unit Cost$ 1hr
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 O Check#
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'S STJRt T PERMIT MANUAL.
Signed: Cg�� Print Name &Uc`n - I V/ l rl Date: �a Ir /
Engineering/p rmi /Street Excavation rerirnL cvs.