HomeMy WebLinkAboutDriveway Street Cut Permits 129 Farnham 700051 TOWN OF SOUTH WINDSOR, CT
PEMgIT;i%:,TJNIBER STREET CUT PERMIT
DATE: 05/21/07
GIS ID: 32100129
MUNIS APPLICATION FEE: 25.00
# 200700704
'< ATE: 05/20/08
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'LOCATION
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NAME: AIROLDI'S INC. `
ORES ; .. iFARNiAM RO
ADDRESS: AD
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SCRIPTION:
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APPLICANT AGREES TO FURNISH THE T . : `
.:.. ,.. LIB OP'BOI f)REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY-E PENSE ?"l" `;TQ "FpsTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THi
P � Z'lVkANI =MILL`ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF OI7 H SI'. R,TU, ?EI I MANUAL.
ISSUED BY DABFECI$ D INSPECTED BY
5/21/200710:30AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: "70 oos CONTRACTOR: /94 ro
LOCATION:___ ADDRESS:
TYPE OF WORK:_ 7
DATE INSP NEEDED: DATE INSP: a;(a�
INSPECTED BY:_ Rn
WORK IN
PROGRESS: L �,
.INPUT: ` DATE: '� 3
APPLICATION FOR STREET EXCAVATION PERMIT 000 ,�r
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
�:' --,Name of Firm �o � 5 ��c._ Phone No.
Address of Firm o _Q� �. `1 \ �2j�,��\� �� Sov C 7 S�, Lor),.+
Location of proposed work
Describe fully nature of permit requested
Starting date Approx. time for completion wee\ZS
Call Before You Dig No. `aa0`l ��03 6 a Traffic Services Control No.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No. cuts
Est. Size of Perm. Patch(s)
l Est. Pvt.Thickness in.
1 1 Est. Unit Price$
rS� Amt. of Deposit$
Total Due$ by
( ) Cash( ) Check#
Permanent Patch
1
No. Cuts
Size of Patch(s)
Final Billing
Amt. Due Payee
Amt. Due Town
By
Applicant is responsible for contacting Date
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
CONNE WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMIT S OSINE N THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: r)
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES