HomeMy WebLinkAboutDriveway Street Cut Permits 928 Pleasant 700046 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 05/1
GIS ID: 72900928 ,.::.
FEE:MUNIS APPLICATION# 200700684 ''`b:r 25.00
`<.` EXf'IRAT ION DATE:
05/16/08
AP NT"
P L C A NAME: BLUED IAMOND
N
',>i LOCATION
PAVIGTN ,'`.".°": '..
:.V9 &.PLEASANT V
ADDRESS: 1064 EAST ST NORTH °0: ALLEY ROAD
p ERTRUDE&ARTHUR
O BOX 273 `
<;: `
s'E.A, T V
SUFFIEL f::
AN L Y RD
D CT 06078' ��' T=
r"'' .."..Ft3
PHONE 800_728_ :. IN DSOR,CT 06074
4644
�y
J:
WORK DES
CRIPTION:C RI PT IO N•
D RI
Y:. :
APPLICANT `
AGREES TO FURNISH THE'I:; < """"
THE :: OiJ I'OPQ >REQUIRED
TOWN
OF SOUTH WIND SOR FOR AN�':ENS> B FOR
MTNTE A�TO REIMBURSE
IN
CONNECTION WITH THIS PERMIT AND THEE. PAl'1fiTIfi.F" '' ilk:: >; L �E BY HE RULES AIND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFOU1fjST
R11I',GUI ? RT MANUAL.
ISSUED BY
D:.. INPED INSPECTED BY
5/17/200711:44AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL
***
i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: -7 0 CONTRACTOR:_'61"
LOCATION: b ADDRESS:
y
TYPE OF WORK: Y'\ �`'e U'D a
DATE INSP NEEDED: DATE INSP: /z
INSPECTED BY: i
WORK IN
PROGRESS:_
Al
�j
INPUT: DATE:_
0511712007 12: 21 CONNECTICUT CALL BEFORE YOU 0I6 Page 1
e
(CALL BEFORE YOU DIG - CT) 05/17/2007 12: 21: 20
-5G -Cl -GV -OT
8-SW SWINDS -T5 -W3
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< <RESEND>> ***** ROUTINE *****
TIME. . 10: 46 DATE. . 05/17/2007
REQUEST NO. . . 20072003125
LATITUDE. . 41. 8103314 LONGITUDE. . -72. 5829440
TOWN. . . . . . SOUTH WINDSOR
ADDRESS. . . 928
STREET. . . . PLEASANT VALLEY RD
NEAREST
CROSS STREET. . ELLINGTON RD
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TYPE OF WORK. . . . . EXC TO RMV/RPLC DRIVEWAY
AREA IS MARKED. . . YES
REMARKS:
WORKING FROM STREET TO GARAGE
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START DATE. . . . . . 05/22/2007 START TIME. . 07: 00
CALLER. . . . . . . . . . ED SALAZOWICZ
CALL BACK. . . . . . . 8-5
PHONE #. . . . . . . . . 800-728-4644
FAX #. . . . . . . . . . . N/A
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . . BLUE DIAMOND PAVING
ADDRESS. . . . . . . . . P 0 BOX 273
CITY. . . . . . . . . . . . SUFFIELD
STATE. . . . . . . . . . . CT
ZIP. . . . . . . . . . . . . 06078
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EXCAVATOR DOING WORK. . SAME
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED:
7Oba�-
APPLICATION FOR STREET EXCAVATION PERMIT Permit No.
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR$ CT 06074 1 ,J
FE 1$25 00 2610 1)c�' �"l u I
f Firm u.,2_ • � , III �f Phone No.
1
Name o ,
Address of Firm
Location of proposed work
IrL 1J '�
Describe fully nature of permit requested '
Approx.time for completion
Starting date —177�
s Control
Call Before You Dig No. BS � � —Traffic Service
I) No.
This section to be filled out b
Show sketch of proposed work or famish indicate Nash Town of South Windsor
two copies of separate drawing Pavement Cut
No.cuts
w Est.'Size of Perm.Patch(s)
Est.PvL Thickness
Est.Unit Price$
Amt.of Depositby
$ --
-- -Total Due$
_ ( )Cash( )Check#�_
. 1 Permanent Patch
No. Cuts
t Size of Patch(s)
j Final Billing
$
Amt.Due Payee
--- Amt Due Town
$
. By
MsURSE THE
plicant is re nsible for contactin .
the Police De t.and C.B.Y.D.
I AGREE TO FURNISH T O THE TOWN OF SOUTH WINDSOR THE AMOUNT WN DOR MAINTENANC OR REPAIR WORK IN
TOWN OF SOUTH WINOSOR FOR ANY EXPENSES INCURRED BY THE TO
FOR
CONNECTION
WITH THIS PERMIT ANO THAT 1 AM FAMILIAR WITH STREET
IT PERIM TBMANUALR.ULES AND REGULATIONS
PERMITS AS U-fLINED IN THE TOWN OF SOUTH WINDSOR'S STR
�A Date:
Signed: 4
Driver's License#:
-Title:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES