HomeMy WebLinkAboutYard drain to driveway to CB (no rd cut 700202 - TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 11/30/07
GIS ID: 11400141
»' FEE: 25.00
MUNIS APPLICATION# 200701948 " ` 'k
<xAll WATI0N DATE: 11/29/08
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APPLICANT;: r x : ::: fl: . <-f::<<:fr ::;
LOCATION
NAME: SKIPS SEPTIC '
`:rRES r, '.4 1'BIRCH:HILL DRIVE
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DRESS: 27 MUDDY BROOK ROAD> RICH:.;:
. EpNARD S JR FAMILY TRUST THE
ELLINGTON CT 06 t f.
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H L DR
'S WIN SOUTH D CT 06074
PHONE —860 875-23 32
WORK DES
CRIPTION:
TION• YA RD`DR
IQ. CUT NEEDED
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APPLICANT AGREES TO FURNISH THE TOVN; I iTH: Tt ` i0i +'l7F; tjl•Jn RE UIRED AND TO REIMB Q URSE
THE TOWN OF SOUTH WINDSOR FOR ANYlK
P'TlS1 511*IYtII "Ip7'F 'I1%IINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APP' I 1Li1T`I E III :R. I I'LAND"V`ILk` BIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF Sb JTTT T 1 $R.`§'YF EE 1 Q'U<'pERNJI`I MANUAL.
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ISSUED BY DAT—EINSPECTED INSPECTED BY
11/30/2007 3:37 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: '7 CONTRACTOR:_
-v. . LOCATION: ! y I
TYPE OF WORK: `)a�d .'
L--�Ci-
DATE INSP NEEDED: DATE INSP: //LL1I
INSPECTED BY 6a
WORK IN
PROGRESS:- wa,4a✓ 4 4 � �t c t4 3,;
AS-BUILT:
INPUT:— DATE:
W12007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm I e5 Sir 77C OCT O C4 Phone No.
Address of Firm �- dd ec��- /71 —
Location of proposed work
.Describe fylly nature of permit requested 6L c� rf
� -3'D ^V
Starting date �- Zcx>Tj Approx. time for completion 1
111111(
Call Before You Dig No. v0 "]I
Traffic Services Control No. �
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out by
Town of South'Windsor
Pavement Cut
No.cuts
Est.Size of Perm.Patch(s)
Est.Pvt.Thickness in.
q, Est.Unit Price$
cl�" Amt.of Deposit$
Total Due$ by
( )Cash( )Check#
Oro 0
y I �V C4 Permanent Patch
v E y
LNo. Cuts
CL !{ �
Size of Patch(s)
®Zr3' An
Final Billing
Amt.Due Payee
Amt.Due Town
By
Applicant is res onsible for contactin
the Police Dept.and C.B.Y.D. Datp
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
CONNEC ION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMIT S OUT IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:_ (� �� t 1
Title: W Driver's License#:_ D7119 0P 1
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES