HomeMy WebLinkAboutDriveway Street Cut Permits 229 Avery St Permi t iaQ-. 3450
Date"" 04/01 /2003 1-oydrl of South Windsor, CT
Street Excavation Permit
Expiration Date 03/31/2004
Descrip : INSTALL DRIVEWAY
Applicant
Location
Name AIROLDI 'S INC. � G229 AVERY STREET
Addr. 41 ZINFANDEL CIRCLE
TOLLAND CT 06084
Phone (860 )896-0401 ypo of, Work DRIVEWAY
Applicant agrees to 'furniSFK-,the Town of SOUth �Wjndsor the amount of bond
required and to reimburse 'lrhe' �;T'own `o=� ,So,uth W`In+ sor� 'fir any expenses
incurred by the Town for ►iiafntena3!de 'orI repai r wQrk in connection with this
permit and that app 1 i cant s, am i 1.i ar WJt6 and "w J T abide by the rules and
regulations for permits as ,;dutlined in the .lowri ;.of South Windsor's Street
Cut Permit Manual .
* * PERMIT 1-0 BE KEPT; ON =JC?B SI! E AT ALL TIMES.
Issued by r r f-
Date Completed Inspected By
I
TOWN OF SOUTH WINDSOR INSPECTION REPORT
r s
Permit No. 3450 Contractor AIROLDI ' S INC.
Location 0229 AVERY STREET Address 41 ZINFANDEL CIRCLE
Type Work DRIVEWAY TOLLAND CT 06084
Phone No. ( 860 )896-0401
Date Insp Needed Qate ,Insp Awe
Time Insp Needed Time, Ins r�lC
p: L
Inspected By
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Work in Progress
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Input Ci_� Date
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm / 1 I-C%1 C�k }S Aft)C _ Phone No.
Address of Firm P" (-
Location of proposed work �i 'sv
Describe fully nature of permit requested fLu e \-,"`U
Starting date Levi 0), 14- I-03 Approx.time for completion�,� :� -1-0
Ca11 Before You Dig No. Z S I.�c)l 1 3`"1 TraS`iic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North : Prop. size of cut
No. cuts
Amt. of Deposit$ by
,jA ()Cash ()Check#
I Cut size after Perm. Patch
I c� No. Cuts
Final Billing $
v
Amt. Due Payee$
-- -----= Amt. Due Town $
Applicant is responsible for contacting by 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 MANUAL.
Signed: AO Date: 3 5
Title: S/-t A-e_1' D.L.#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc