HomeMy WebLinkAboutDriveway Street Cut Permits 498 Buckland TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4290 Cont. aC' br J & I�'`57rA�ER CONST CO
Location .,"' Address, 75 Gf) II ,RCE 'WAY
Type Work DRIVEWAY
S0,VTH WTNIJ OR. CT:;,06074
Phone No
Date Insp Needed
Time Insp Needed I Rle: Ir�sp Q,
Inspected By
:
Work in Progress1�
y
a
Permit No. 4290 Town of South Windsor, CT
Date 09/14/2006 Street Excavation Permit
Expiration Date 09/14/2007
Descrip:
Applicant
LoGati,o�
Name J & H SLATER CO14ST CO ¢v498 UCKLANF3<ROAD:,;
Addr. 75 COMMERCE WAY
SOUTH WINDSOR CT 660' 4 Type 6f Wor3 , T:ES41y
Phone
860 528-
5252
Ap
plicant
nt agreed
ees
PP g u ,n�sl�> t.h�e:.:'�A":' <a�i,:<;' `"�;.''. Win `>'
X+?� _��? ��.., d5p'r:?the''<>.:amgiint of bond
required and to reimburse the Took its 5�tbkt I+� $ � any exp2nses
incurred by the Towrs. fpr mateuance or repair .worl 1n Calon with this
permit and that applicant zs 'fatilaar: t ,'wi11,:blde by the rules and
regulations for g permits a oti lines 32i the Ti a of S4u1-h, 0i:n sor's Street
Cut Permit Manual.
K,
* * PERMIT TO B °°K P •ON �C1$ }5I1E AT AT:D:;:,TI 1ES.
Issued by —__ 'FitT`C' k�!✓! -
.Date Completed _—__--_---- Inspected By 099 ���
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR ------
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm boffcL
Address of Firm '� Phone No.
Location of proposed work
Describe fully nature of permit requested
Starting date
Call Before You Dig No. Approx. time for completion
Traffic Services Control No.
Show sketch of proposed work or fumish
two copies of separate drawing Indicate North This section to be filled out by
Town of South'Windsor
0 Pavement Cut No.cuts
Est Size of Perm.Patch(s)
Est.Pvt.Thickness
in.
Est.Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check# .
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
Amt.Due Town
Applicant is res onsible for contacting
By
the Police De t.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 OUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONN TIO WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PER TS AS UTLINED E TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:
Date:
Title:
Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES