HomeMy WebLinkAboutDriveway Street Cut Permit 25 Alison Dri Permit No. 4038 Town of South Windsor, CT
Date 07/15/2005 Street Excavation Permit
Expiration Date 07/15/2006
Descrip:
Applicant
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Name M&S PAVING AND yAI3dC INC C42 A7, t�2 bRIV
Addr. 435 BUCKLAND ROAD
SOUTH WI
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WAY
Phone 860 ` "
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to
Applicant can 1'
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i t agree,
ri3sh the `e3w if Q th Wi cksp Ghe am
punt of bond
required and to rembux�Ae the Town ogx1x tg3J}dsor o atty eatpenses
incurred by the Town for m$�Xke3� k
& j �p z work -n"CQhnec,tVon with this
permit and that appl�.e; n �t:itrNmiliar witT� anc `C3'iL. article k;....tie rules and
regulations for permits as 6tit3inz3" 'h
.. rpixth :Windsor s Street
Cut Permit Manual. 3 a yt s
* * PER
MIT''16 ..4,8"XiFT;, ON :;'S.
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ued by
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Date Completed
t ed By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4038 > '
F , � ctI M&S �PAVIftGv:;.:AND SEALING, INC
Location 0025 ALISON DRIVE Aga e' s � 35 <�
Type Work DRIVEWAY KL ND ROAD
f �fIt IND�S,0''R CI.>.06074
8 9'U
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Date Ins y`
P Needed `1 t.•.�.' s
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Time Insp Needed
Inspected By
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Work in Progress ..
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�`+�"�"�-�t►/yIIUN FOR STREET EXCAVATION PERMIT .59
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm f S -PiiC v)Nf 6 7j j U � ���_1 �/
Address of Firm S— �C Phone No p 7
Location of proposed work (fit 1f e
Describe fully nature of permit requested P
�7 Ilfr
Starting date_ - 11• a
Call Before You Dig No. ApprOx.time for completion /•p�
Traffic Services Control No.
Show sketch of ProPosed Work or furrdsh
two copies of separate drawing _ Indcate North Ibis section to be gped out by
rows of South Windsor
Pavement Cut
F
No.cuts
Est.Size of Perm.PawKs)
Est Pvt.Thickness
Est.Unit Price
Amt.of Deposit$
Total Due a by
( )Cash( )Check#
Permanent Patch
5 } No. ctts
Size of Pak*Ks)
Final Bing
Amt.Due Payee
a
Amt Due Town
ey
Applicant is responsible for contac ft
the Police Na and C.B.Y.D. Date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR FOR TOWN/WY OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK I
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH ANp WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERM S AS INED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL,
Signed:
Date: —7-1/ - d�
Title: � � 1 1���
Driver's License#:
PERMITSHALL RF ICFarnU_InRcrrc wr^s e "em,