HomeMy WebLinkAboutDriveway Street Cut Permits 206 Bourbon ' Permit No. 3809 Town of South Windsor, CT
Date 07/30/2004
Street Excavation Permit
Expiration Date 07/30/2005
Descrip:
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Applica t
Name AIROLDI'S INC. p: BO�JI2BOId::S'TR`ET
SOUTH WINDSOR C6f57it . yae A7�::"'"'r'
Phone (860)289-3876 ; a
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Applicant a reel€ 60-' 3?j1!:' h'.:.'the To:W'n';.. . ^` ''! : Win :qY',t e%'a
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required and to reifa—r;�7a t e',, •;:3 a S'or f r;._'Ah a t)e:#�ses
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incurred by the Town, fn i9t .nari " i1t$a} i `r` f `., i.€ �,r:ranactipn with this
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permit and that appl3c `105.... _ rules and
regulations for permits as. a. Street
,': � �j�ti5 i:�� So�tl�.#� �.inds�r's Street
Cut Permit Manual
* * PERMIT TOtk::$" TT$;.:AT' 'A.T4 T•IME.�I.
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Issued by � � `�.. :...��4 `� i t 1 ---------------
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Date Completed — Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3809 Contra'4�f' 'r>"AIRO `FJfi`65:...INC.
Location 0206 BOURBON STREET F�cidres. °g O a 6X# rl
Type Work DRIVEWAY `"`s y:t °'
{ ySI7TH [f 'N" R CT 06074
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Time Insp Needed +. z�kF"
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APPLICATION FOR T.REET EXCAVATION PERMIT
SOUTHTOWN OF I S
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25�00
Name of Fir►n` Phone No,
Address of Firm` , "�\ ` a e - -�- C C_' -)\-a
Location of proposed work -~��-
Describe fully nature of permit requested --
Starting date \�i� Approx.time for completion i
Call Before You Dig No`'; 'i� ?�� 1_:� Traffic Services Control No.
Show sketch of proposed work or furnish To be oiled out by Town of South =ndsojr 1
t,wo copies of separate drawing l
Pavement Cut
Indicate North Prop. size of cut i
No, cuts
Amt. of Deposit$� b;.,
()Cash ( ) Check#_
Cut size alter Perm. Patch
No. Cuts_
Final Billing
Amt. Due Payee i
Amt. Due Town
Applicant is responsible b}I_ _ date_
the Police Dept. and C:B.Y.D. .-
I AGREE TO FURNISH TO THE T OWN 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 CONINE -)N 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: w_
Title: X D.L.#:
PERMIT SHALL BE KEPI"ON JORS;�'E AT ALL T It4ES
Standard Forms\Permits\Street Excavation Permit.doc