HomeMy WebLinkAboutStreet Cut Permit 108 Andreis Trail1000004 TOWN OF SOUTH WINDSOR, CTPERMITNUMBER
STREET CUT PERMIT
DATE: 01/12/10
GIS ID:03300108
3 FEE:25.00MUNISAPPLICATION# 201000022 t TION DATE: 01/12/11
APPLICAN 3 ` TIONNAME:CABLE CONSTRUCT Ik VDAILADDRESS: P O BOX 159
3 .
R ALLEN W&DEBORAH CMIDDLEFIELD,CT 0 4 Ta 8 IS TRAIL
3 OI H V][NDSOR,CT 06074PHONE860-649-8217 s
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WORK DESCRIPTION: HAN T L
APPLICANT AGREES TO FURNISH THE TO ND REQUIRED AND TO REIMBURSETHETOWNOFSOUTHWINDSORFORANYEAINTENANCEORREPAIRWORKINCONNECTIONWITHTHISPERMITANDTHEII ` LL ABIDE BY THE RULES AND REGULATIONSFORPERMITSASOUTLEDINTHETOWNOFSOIE2ITMANUAL.
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ISSUED BY DAT INSPECTED INSPECTED BY
1/12/20108:41AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 106M& q CONTRACTOR: 0-ab1e- CpaslR.
LOCATION:_ I0
TYPE OF WORK: Pan d 1 G ±dww b he Sy i f 4T u
DATE INSP NEEDED: DATE INSP: 3//(zlFC)
INSPECTED BY: 6b
WORK IN
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PROGRESS: resc
L.,--ems Clr 0_. 7 S(2
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED YES NO
AS-BUILT:
INPUT:_ DATE: 1
W/2007 Town of South Windsor INPSECTION REPORT 07
a I0 0022- APPLICATION FOR STREET EXCAVATION PERMIT .1 QC000 q
Appl. No.TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm 0 CA byle &OS! c t i Xo- G. Phone No. %6_3V?—(
Address of Firm 6f Zip Code r S;
Location of proposed work
Describe fully nature of permit requested HAdd ale C e
Starting date / / c7 Approx.time for completion
Call Before You Dig No. tol00 QQ3$,6
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 filled out by
two copies of separate drawing Indicate North Town of South Windsor
No.cuts0Est.Patch Size(s) sf
Est.Pvt.Thickness in.
Est.Patch Unit Price
Est.Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ft
Est.Curb Cost$
Est.Traffic Unit Cost$ hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
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 AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
Title: Driver's License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Street Excavation Permit 08