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HomeMy WebLinkAbout55 Oxbow Ln - Permit, Inspection Teport, Application with Sketch, & Drawing1900096 PERMIT NUMBER BATE: 06/20/2019 GIS ID: 67800055 MUNIS APPLICATION # 201901294 APPLICANT NAME: TELE-NETWORKS ADDRESS: 31 BAKEWELL COURT CRASTON, RI 02921 PHONE 401-461-8420 WORK DESCRIPTION: REPLACING EXISTING CATV TOWN OF SOUTH WINDSOR, CT STREET CUT PUBLIC UTILITY FEE: 50.00 EXPIRATION DATE: 06/19/2020 LOCATION ADDRESS: 55 OXBOW LANE OWNER: COSTA MARIO J JR & JULIANA T 55 OXBOW LANE APPLICANT AGREES TO FURNISH 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 THE APPLICANT IS 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. ISSUED 6/20/2019 12:30 PM DATE *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** INSPE-- CTE B TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.' -.I 000'76. CONTRACTOR:. L lr°"—8220'L 5l LOCATION: 5 J ©x �� /7 r . p TYPE OF WORK: DATE M.SP NEEDED:-. CRATE INSP: / 1r7 INSPECTED BY: WORK.IN PROGRESS: CAT' c� SEPTIC TANK PUMPED, SMASHED; FILLED WITNESSED ❑ YES ❑ NO AS -BUILT: INPUT: C\w1 DATE: S/mollcy/forms 2014 Town of south Windsor INPSEC 1(jN 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 NameofFirm T��f' [\ 4wor<.- Phone No. ss 8US 230Z Address of Firm S W. VA F Sl - C(N eoce T- Zip Code O Z9 D Location of proposed work4 Qkl&W Cn Describe fully nature of permit requested rep ( h CP}T Starting date 9/da Call Before You Dig No 14I94PZ l/ a PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT 15 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 Pavement 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 two copies of separate drawing Indicate North This section to be filled out by Town n B p �,� � C•� No. cuts 0 Est. Patch Size(s) Sf Est. Pvt. Thickness in. Est. Patch Unit Price $ /sf Est. Patch Cost $ Est. Curb Replacement It Est. Curb Unit Price $ /ft Est. Curb Cost $ Est. Sidewalk Replacement sf Est. Sidewalk Unit Price Est. Sidewalk Cost $ Est. Traffic Hours hr Est. Traffic Unit Cost $ /hr Est. Traffic Control $ Amt. of Deposit $ _ DRIVEWAYS must be aft or more from the property line per Total Due section 2.17 of the zoning regulations Applicant Is responsible for contacting the Police Dept. and C.B.Y.D PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES ( ) Cash ( ) Check# Paid By 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 S REET CUT RMIT MANUAL. n/ ((��,,,`/� Signed: a✓� Print Namepp�rA�i.S V AM IJ" Dale: w Engineering/g€rTitr/Street Excavation Permit 2017 Notes: + Ov Dale Geata l W11120191119.49