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Permit No. 4135 Town of South Windsor, CT
Date 12/29/2005 Street Excavation Permit
Expiration Date 12/29/2006
Descrip:
Applicant
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Name VIOLETTE SILVESTER & SONS:fftO9 ARNOLD WAX
Addr. 65 CHERRY STREET..
EAST HARTFORD CT O61O8 T7e of t9cJrk 3EW SAN LAT ?
Phone (860)289-3466
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Applicant agrees to .ft the To,,m .s�f Sa zth Wind ox the a'aiznt of bond
required and to reimbz' e -khB. 1O6�t ; ::` cuthT�xzrt�r fesr. any expenses
incurred by the Towr$ r mrrgtgi.nanCe or r2pir 'WorknQ.xine.ction with this
permit and that applicant i"' >"::::::;:-">`;: ' ">..: :>:<::<_-:: >...;__;_;..::>.:.;<,:.
mfli :..:u.3s b.;,:�x : : w311:. a.1. liytke rules and
regulations for perms- -s aq.. 6Vt`AH'6 ' ='">''
:.t .'Ios : of Scut: t4; ,3 d or s Street
Cut Permit Manu
al,
* * PERMIT TO
KPly,.,Ol�`:=;.Jd$:,'` :�TE< ATL.
Issued
ed by I
Date Completed ----_.....--... Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4135 Cont.x.ae `or VhOliLTTE:;:,SILVESTER & SONS
Location 0009 ARNOLD WAY At3dresµ ` 65 CHERRY STREET
Type Work NEW SAN LAT : ;AST HkRT:F, RI) C ,. 06108
Phone :No (8�0')2S9 `34,66 :..
Date Insp Needed bath Tp 1;.
Time
Ins Needed
p 1 ijqe TIa� A
Inspected By
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Work in Progress
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
/ FEE $25.00
Name of Firm V o/e//t s pCS4 v Phone No.
Address of Firm
Location of proposed work ��6
Descri fully nature of permit requested �^c,�-r
L° hac,/ -�b
� ro c
Starting date
Approx.time for completion_____.a
Call Before You Dig Na. 12��`Se?d C ��/ Traffic Services Control No.
Show sketch of proposed work or fumish
two copies of separate drawing Indicate North This section to be filled out by
_ Town of South Windsor
Pavement Cut
r No.cuts
1
Est.Size of Perm.Patch(s)
Est.Pvt.Thickness in.
' Est.Unit Price$
` Amt.of Deposit$
Total Due$ by
( )Cash( )Check#
L�5 Permanent Patch
e, No. Cuts 0 _
Size of Patch(s)
Final Billing
/a 7ir¢/ Amt.Due Payee
S'Cw a►^ v►'t a r y I'9 h� $
Amt.Due Town
Yb �4e ccly 3N of
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
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT M NUAL.
9
Si ned: 1 Date: /Z � 7 O S
Title: Driver's License#:_ 15-1 d?-� /r,
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES