HomeMy WebLinkAbout23 Woodland Dr - Permit, Inspection Report, & Application1500153
PERMIT NUMBER
DATE: 07/21/2015
GIS ID: 96900023
MUNIS APPLICATION # 201500953
APPLICANT
NAME: BARBER UTILITIES LLC
ADDRESS: 35 PINNACLE ROAD
ELLINGTON, CT 06029
PHONE
TOWN OF SOUTH WINDSOR, CT
STREET CUT PERMIT
FEE: 0.00
EXPIRATION DATE: 07/20/2016
LOCATION
ADDRESS: 23 WOODLAND DRIVE
OWNER: POWELL RENEE M
23 WOODLAND DRIVE
South Windsor, CT 06074
WORK DESCRIPTION: WATER TIE IN (IN FRONT OF #23 WOODLAND)
AVERY STREET PROJECT NO FEE
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 BY
DATE INSPECTED
7/21/20159:38 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I.5-6a / i- CONTRACTOR: a l' ,,1, �/'Ls-
LOCATION: lt✓ 9 12 2,3
TYPE OF WORK: iA)q le-i 416 / n✓ - 42e9 Sf L4t�O_
DATE INSP NEEDED: '7 -15-1'�; DATE INSP:
INSPECTED BY: hP
WORK IN
PROGRESS:
Wc-a�L c
on.,p(Yz7flip. C,fi.rRAC,iorz.
IN°-TP-vc rrr,
PA <AleA,r
�rrC J
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS -BUILT:
INPUT: DATE:
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
Appi. No.
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00
Name of Firm_{ � Phone No.-CCI .
Address of Firm j_E t K4t i. l _ Zip Cod _
Location of proposed w
Describe fully nature of
Starting
req
Call Before You Dig
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY
INCREASES IN PATCH AREA, CURB LENGTH, TRAFFIC CONTROL AND THE TOWN'$ 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 IN Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: 14 Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish
two copies of separate drawing
. 03\el
'� \KN
.y
Applicant is responsible for contacting the Police Dept. and C.B.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Indicate North
This section to be filled out by Town
No. cuts
Est. Patch Size(s)
sf
Est. Pvt. Thickness in.
Est. Patch Unit Price
Est. Patch Cost $
Est. Curb Replacement
it
Est. Curb Unit Price $
!fL
Est. Curb Cost $
Est. Sidewalk Replacement
sf
Est. Sidewalk Unit Price $
!sf
Est. Sidewalk Cost $
Est. Traffic Hours
hr
Est. Traffic Unit Cost $
/hr
Est. Traffic Control $_
Amt. of Deposit $
Total Due $
( ) Cash ( ) Check #
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 WN FOR
ITH THIS PERMIT AND
THAT I AM FAMILIAR WITH AND WILLOMAINTENANCE
AB DE BY THERULES ANDN
REGULATIONS FOR PERMITS AS OUTLINED yTHE TOWN OF SOUTH
WINDSOR'$ry /E�ET CUT PERMIT MANUAL. (�,�t�� �� �F�)
Signed: �1VVY 1 !� __,._ Print Name k- �` -- — Date:�"r't