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HomeMy WebLinkAboutReplace concrete sidewalk Street Cut Per •v Permit No. 4217 Town of South Windsor, CT Date 05/10/2006 Street Excavation Permit Expiration Date 05/10/2007 Descrip: REPLACE CONCRETE SIDEWALK Applicant Laq .t` on Name COSTA & SON, LLC 0tf:0 3Yt2N614D WAy Addr. P.O. BOX 658 SOUTH WINDS OR C 06>.074 Te a$ :Work IuIISCELLAN Phone (860)644-2499 Applicant agrees Gt� >'furnisl� the .T©wn,fl. Szst:h Wine3&o bhe artount of bond required and to rermbur:se. the., Town o au:-. U.dsor for at�y xpezises incurred by the Town folt Mwlg, �natlq r r�pa tAttYrk ig 40nT echo with this permit and that appl' .... s famrli' Y wit'kt anc3 >vrrll b de `b the rules and regulations for perm >,ts`"as 'ouz'. S©iith Wihd89r s Street Cut Permit Manual. PERMIT TO BE-'fiC;.�PT QN 3F3-: T AT A1.Z 'jIMEE .'"* �j y Q�f�� Title ✓ �G Issued b -- + Date Completed B ---------------- L � ect'ed TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 4217 Contxac'tor COSTA & ''SO LLC Location g�q@Y A: P . 80 65re8 . 8 Type Work M"1SLLAN SOUTH- WINDS'OR CT,06074 PProne_No (86fl',j644-249 Date Insp Needed p . ------------- --- bats ns I Time Insp Needed T me :Ixx ; f :. Inspected By Work in Progress _ c' ., APPLICATION FOR STREET EXCAVATION PERMIT 42 r� TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm U A `+� w V I" Phone No.Address of Firm (, r , ( u C4 Location of proposed work ';r Describe fully nature of permit requested %(itA(J? Starting date Call Before You Dig No. Approx. time for completion Traffic Services Control No. Show sketch of proposed work or famish two copies of separate drawing Indicate North This section to be filled out b Town of Sout WWindsor Pavement Cut No.cuts Est.Size of Perm.Patch(s) Est.Pvt.Thickness in. Est.Unit Price$ i ( Amt.of Deposit$ Total Due$ by Q 1.n d�� •q iJ ( )Cash( )Check# . Permanent Patch No. Cuts Size of Patch(s) Final Billing Amt.Due Payee Amt.Due Town By Applicant is res00 risible for contacting the Police De t.and C.B.Y.D. DatP 1 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.�t ON WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMI OUTL NED iN E TO N OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: t � •'!� � Date: Title:_ Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES