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Home My WebLink About350 Pleasant Valley Rd - Butler Company - Permit, Application, MDC Cut Sheet, & Sketch9/3/21, 11:10 AM 0 6*174 Permit Number: ESE-21-226 Application Date: September 3, 2021 Contractor Name: Contractor Address: Phone: Email Address: Town of South Windsor Engineering Department Street Excavation Permit Applicant Name: IThe Butler Company Applicant Address: 8 Marshall Phelps Road 06095 84 indsoc CT Base Permit Fee: $50 Plus additional charges as applicable Expiration Date: September 3, 2022 Location Property Owner: 1350 PLEASANT VALLEY ROAD LLC Location of Work: 350 Pleasant Valley Road Utility Name (if applicable): MDC Type of Work: Utility Company Work Description of work: Patch roadway and driveway apron after MDC water main break Date work will start: September 7, 2021 Type of Utility (if applicable): Water Valid From: September 3, 2021 Expires on: September 3, 2022 P"V /'rt&af� September 3, 2021 Jeffrey Doolittle, P.E., Town Engineer Date Signed 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 repair or maintenance work done in connection with this permit. The Contractor assigned to this permit has a valid Drain Layers License issued by the State of Connecticut and hereby agrees to abide by all the terms, conditions, rules and regulations of permits as outlined in the Town of South Windsor's Ordinance, Drain Layers Permit Manual, Public Improvement Specifications, State and Federal OSHA requirements and any other applicable conditions. 1/1 APPLICATION FOR STREET EXCAVATION PERMIT Appl, No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 Name of Fi Address of Location of Describe fu Starting Permit No. FEE $50.00 Call Before You Dig No 0061 3�1o''3gRln 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 TOWNS 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 O 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 Indicate North This section to be filled out by Town two copies of separate drawing No. cuts 0 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 $ �y/^Ig Est. Sidewalk Replacement sf I1 J �(/ Est. Sidewalk Unit Price Est. Sidewalk Cost Est. Traffic Hours hr Est. Traffic Unit Cost $ Itlr 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 ' ( ) Cash ( ) Check # Applicant is responsible for contacting the Police Dept. and C.B.Y.D PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES 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 STREET CU t%MA UAL.: Signed:=t Print Name 4>!t & f );/ Date: Engineering/permits/Street Excavation Permit 2017 M0.0, Rev 2t12 THE METROPOLITAN DISTRICT - PAVEMENT CUT CLOSEST DRAW SKgCH SHOWING LOCATIO CROSS SECTION OF oa,v u SIZE OF CUTS AND ,,?Cti,G r DATE: ( ` BILL JOB D YES 2f� WO#,:)n 44 TOWN-�L.7) LAD IkASA-3ndZ STATE HIGHWAY DYES pro MADE IN �CUTT i; S HEET 9errQM,-7—° D CONC._' ❑ PREMIX " ❑SIDEWALK ❑BrrUM.__° 000NC.__ ❑FLAG ❑CURB ❑BITUM._OCONC._' OSTONE DaRIVEWAY �Bil UM.y " D CONC._" — ❑ GRASS LOAM & SEED NEEDED ❑ YES 21z- REASON FOR CUT: r:Py4 l' 9 !w-t- ew •}''! •? ,� DEPTH OF EXCAVATION:_ NUMBER OF CUTS: DATE OF FIRST CUT:_ aLf ��I IS JOB COMPLETED`_ aTrS ONO REPLACEMENT PAVEMENT CONTRACT NO BITUMINOUS ❑ CONCRETE ❑ PREMIX ❑ DATE COMPLETED: ACCOUNT NUMBER:_ C Tr7 ITEM # ITEM# ITEM# ITEM#