HomeMy WebLinkAboutDriveway Street Cut Permits 99 Quarry Br 700045 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
s STREET CUT PERMIT
DATE: 05/09/07
GIS ID: 74100099 3`
MUNIS APPLICATION# 20070 p'' >` h.:. _> FEE: 25.00
0630 "'
"" EJRATION DATE:
>' 05/08/08
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AP
PLICANT-,
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NAME: AIR OLDI'S INC `:;,� •.., l;: :. ON
ADDRESS: UARRY BROOK DRIVE
SS: P O BOX 71
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SOUTH WINDSO G.T.o- :"::.<:. :.'.. <s.:4.,;,, AEL A
R' k99: :i7AIt-Y BROOK DR
PHONE AND R,CT 06074
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APPLICANT AGREES
TO FURNISH THE TIJ WN OF:SOU
':: ITP O.F$<7Latb REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN :ENS: .i? 1 FY T I T Ft3 M IINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH -APB I.CM4,T.. SS "iv( x y > .:; ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF=:SOUIIIS ? U =:PtE T I MANUAL.
ISSUED Bir
DAT ED
p PECTED BY
5/9/20072:35PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ;.
APPLICATION FOR STREET EXCAVATION PERMIT
' TOWN OF SOUTH WINDSOR Permit No.
r PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm ��`���� S �-:-�� - Phone No.
Address of Firm
Location of proposed work__
Describe fully nature of permit requested
Starting date Approx. time for completion
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North0 Town of South Windsor
Pavement Cut
No.cuts
Est. Size of Perm. Patch(s)
Est. Pvt.Thickness in.
Est. Unit Price$
Amt.of Deposit$
Total Due$ by
U ( )Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
_ Final Billing
a\� 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
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERM TLINED`IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
Title: Q7 Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Y
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /0LO 145"'
CONTRACTOR: I (z)f,// .S
LOCATION: 0 ADDRESS:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:_ Ze--4�
INPUT: ('Vy,-- DATE: l d- - -2 -61