HomeMy WebLinkAboutDriveway Street Cut Permits 151 Buckland TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 3748 Cont.r:aC'C"or" SPAZ'ZARINI CONSTRUCTION
Location 0151 BUCKLAND ROAD Address SO PAST OFFICE RD
Type Work DRIVEWAYI3 IELb T 060::$2
Phone Nb ,($ A�745' 5683',.
Date Insp Needed
-------- — Date T ns p O�f
— --
"M
Time Insp Needed ---------- „— — Time
s
Inspected By
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Work in Progress
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In put `
p' Date --- 1V—(/
j Permit No. 3748 Town of South Windsor, CT
Date 06/04/2004 Street Excavation Permit
Expiration Date 06/04/2005
Descrip: HEMLOCK DRIVEWAY FOR RV,ERGREEI ,V3A K
Applicant
LocatzQn
Name SPAZZARINI CONSTRUCTION 0151 BUCKLANI), ,J20AA
Addr. 50 POST OFFICE RD "
ENFIELD, CT 06082of Gook lJRIVRWA ,
Phone (860)745-5683
Applicant agrees, t'o fuzn'1Ska the Tawz of �iuth Windsor.:tie a,tnGunt of bond
required and to reimburse ;t'Le. Tosv a of South Y xl sor for i:any expenses
incurred by the Town fOr t4:10 Onante or repaii.
r work 1n..vpnnectiOn with this
permit and that applicant 'is f8ni :l a saath.a d r%1 obi e by "tlie rules and
regulations for permits as, outiried lithe Town of Sottt'h Wand:sor's Street
Cut Permit Manual. "
* * PERMIT TO BE �KEPT. O ALL TIMES.
Issued by
Date Completed _---- Inspected By
TOWN OF SOUTH WINDSOR v
PUBLIC WORKS DEPARTMENT Per
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR; CT 06074
FEE $25.00
Name of Firm
Address of Firm o phone No. 8v10- �-�s_ 6R3
o e�e
Location of proposed work `
Describe fully nature of permit requested
!u
Starting date
Call Before You Dig No._2 Zel f y APProx.time for completion .ylp,,,l
Traffic Services Control No.
Show sketch of proposed work or fumish
two copies of separate drawing indicate North This section to 7dT
Town of Sou
Pavement Cut
� No:cuts
Est..Size of Perm.P
` O i41V one,
Est.PvL Thickness
.
Est.Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check#
Permanent Patch .
No. Cuts
Size of Patch(s)
------- Final Billing .
Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contacting
the Police De t.and C.B.Y.D. Date
1 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 ED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:
Date:___-� -"7_
Title:
Driver's License
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES