HomeMy WebLinkAboutDriveway Street Cut Permits 702 Avery St s Permit No. 3760 Town of South Windsor, CT
Date 06/14/2004 Street Excavation Permit
Expiration Date 06/14/2005
Descrip: CK 8066 $50.00 2PE. ITS
Applicant L4Cat.ibn
Name AIROLDI'S INC. 07:Sf2 AVERYTR.EET
Addr. P 0 BOX 71
SOUTH WINDSOR OT -Q.6074. TYPe of._Wo-rk .DFY2U WAY
Phone (860) 896-0401
Applicant agrees to:`.f.urn3.*5h% the Tawxt c'f Srsuth Wind;sox .the amount of bond
required and to rezmbutse thTown c ou:th War�`dsor for aYtypenses
incurred by the TowU fcrr Mal.ntenance or -..r a "Wrrrk .r# C�Tnl3ection with this
permit and that appliea7it s fam71�> w kt �izd=wi11 abidb.by'th rules and
regulations for permits as outlined' xri the Totdniof SouthTndsor's Street
Cut Permit Manual.
* * PERMIT TO SE KEPT ON .70 . ICE AT A�,dt. TIMES.
Issued by -Title
Date Completed Inspected By ......... ___
' TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3760 Contractor AIROLD.I kS. INC.
Location 0702 AVERY STREET Pddress P O BO7C" 71 `
Type Work DRIVEWAY :43IJTH WINDSOR 6-T. 06074
Phone, No ( 6i})896``0401
Date Insp Needed Data i.nsp
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Time Insp Needed T------------
ime
Inspected By _
Work in Progress
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ate
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Fir�r � yA�c� Phone No.
Address of Fir r
Location of proposed work
Describe fully nature of permit requeste
Starting date t i Approx.time for completion �Q�—
Call Before You Dig N Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No. cuts
Amt. of Deposit$_ y
()Cash ()Check#
Cut size after Perm. Patch
No. Cuts
Final Billing $
Ar i it. 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: Date:
Title:_ D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc