HomeMy WebLinkAboutSanitary Sewer Street Cut Permits 661 Av + TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4250 CoUtYactor LANDIE `CONSTRUCTION, INC.
Location 66 � .4 Address 2I CLAR-KoROR'Y]::;.
Type Work NEW SAN LAT
H;OLT.pN CT:-Q4043<>...
Phone::NCF E860� 46=430.5
tv1 Date Insp Needed
Time Insp Needed
Inspected By
Work in Progresslt: ' K
Ma _
------------------------------- --- - = W —
Input -- Date
Permit No. 4250 Town of South Windsor, CT
Date 06/30/2006 Street Excavation Permit
Expiration Date 06/30/2007
Descrip:
Applicant Lncat:ion
Name LANDIE CONSTRUC'T'ION, INCSTREEz :CHURCH
Addr. 21 CLARK ROAD
BOLTON CT 06043 Type q$ # rk N:EW SAN LAT
Phone (860)646-4305
Applicant agrees to furrtxs the T4xtari 4f Soazh Wiiid`snx the,.amount of bond
required and to reimbur$e the..;Tnwn:,.of Soctth WindsAbt -fZr ariy;- "penses
incurred by the Town f'or masxitenanee nx rep4:it work in cannec.tion with this
permit and that applicant Js Aofi1iar wlCh and<`wi1� ..abide by t;he rules and
regulations for permits.;as ou.tlaned;: an the Town, of 'Snuh Ni.ndor s Street
Cut Permit Manual.
* * PERMIT``TO `BE KEPT'ON JOB :SITE AT ALL TIMES.
Issued by -- --V '—u h Trt
i 2---
Date Completed ____--__— T'ri's' ected B
AIJFL.ICATION FOR STREET EXCAVATION.PERMIT `�a�
TOWN OF SOUTH WINDSOR --.
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm �1�1 ��.�2
Address of Firm Phone No. ��
Location of proposed work T
9q e(E z-C vb
.Describe fully nature of permit requested y -eY\ S�
Starting date
Call Before You Dig No. d)el j 7z� Approx. time for completion__? --
Traffic Services Control No.
Show sketch of proposed work or furnish
two copieso f separate drawing This section to be filled out b
Indicate North
Town of South'Windsor
Pavement Cut
�v
No.cuts
Est'Size of Perm.Patch(s)
/\ Est Pvt.Thickness 'In.
�a Est.Unit Price$
Amt of Deposit$
Total Due$ s7C) by
( )Cash( Check# .7 3 S y
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt Due Payee
Amt.Due Town
By
Applicant is res nsible for contactin
the Police De t.and C.B.Y.D.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR TJ-IE AMOUNT OF BOND REQUIRED AND
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR
CONNECTION WITH TM PER IT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
THE
PERMITS AS O LIN IN THE REPAIR WORK IN
Signed:
O SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. FOR
Date:
Title:
Driver's License#:�
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES