HomeMy WebLinkAboutWater Street Cut Permits 100 Cedar Avenu (2) 1 TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3887 Contract.oxr,-":S-'PPZZ4R,;INI CONSTRUCTION
Location LA FITNESS CENTER AdlCTress, -,%50 P-QST,.OPV-Z-.CE RD
Type Work WATER ENFTELIS; C 06E3..$`2
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Permit No. 3887 Town of South Windsor, CT
Date
11/16/2004 Street Excavation Permit
Expiration Date 11/16/2005
Descri
Applicant P
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Name ZARINI CONST� TFrR.>;"::.:..<s,. .�
Addr.. 50 POST OFFICE � ' ""
ENF IELD CT 0
Phone (860)745-5683
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required and to 4 f z
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ermit and
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" 5<< .... ' by the rules and
regulations for permit's as: outljnec'' vj.,;'. ...':: , ; ,W ;::a Sp W3sor s Street
Cut Permit Manual.
* * PERMIT TO >E F;FT.:.,QN"'6'6g*::
Issued by ----- —'�5 /'�✓— l --- T'3 t 1 e" -------
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Date Completed _--------- Inspected By
v APPLICATION FOR STREE n 7
T EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS.DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm 2 ���
Address of Firm _ _ Phone No.
Location of proposed work UG —
Desaibe fully nature of permit requested
Starting date mac, f y
Call Before You Dig NO. (,� �� �►PProx.time for completion_ --J>,rr•3�s
Traffic Services.Control No.
Show sketch of proposed work or furnish
two copies of separate drawing o be fitted out by Town of South w'ndsor
Indicate North PavemMt IC
Prop.size of cut sr..9 .1
No.cuts f
�. � �%s'X36= z7►o..F�c�o.eo �z.>oo,
Amt of Deposit$ by �—
� � ()Cash()Check#
Cut size after Perm. Patch
�1 No. Cuts
Final Billing$ a
uGj�Ly¢rUp �j,
Amt.Due Payee$
Applica Amt.Due Town$
nt is tesponsible for contacting
the Police De and C.B.Y.D. by date
r I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND
SOUTH'WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTE REQUIRED AND TO REIMBURSE THE TOWN OF
PERMIT AND THAT I AM FAMILIAR OR REPAIR WO
WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR RK IN CONNECTION WITH THIS
TOWN OF SOUTH WINDSOR STREET CUT PERMIT MANUAL PERMITS AS OUTLINED IN THE
Signed: &�-�Jlrv, Y
Date:Jlld 1/. ��i Z �
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PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard ForMAPermitAStreet excavation Permit.doc
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