Loading...
HomeMy WebLinkAboutDriveway Street Cut Permits 895 Chapel R TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3671 Contra g•::;,,,;CONSTRUCTION, INC. _ Location 1"� A;dCl"ress.,::: ::;.3P 0 : RAWER""5:.::, Type Work DRIVEWAY &AST'„GF'ANB CT'"":0.6026 Date Insp Needed > ------------- Date1asi 4��' _ Time Insp Needed 5 ------------- r,. Inspected By Work in Progress ---�'--------- ------ --------------------------- Input _ _ Aafe Permit No. 3671 Date 04/13/2004 Town of South Windsor, CT Street Excavation Permit Expiration Date 04/13/2005 Descrip: Applicant Location Name A.F.S. CONSTRUCTION ., C Addr. P 0 DRAWER S EAST GRANBY CT 06026 Type, q WO ZtyVAY Phone Applicant agrees to fu•r �sh theme. © South Wixadsar tlxe amount of bond required and to reamburse' the.-down of Sitttitisor Eor any expenses incurred by the Town for '`roaa.nenanGe .: rpd wprk ix,'`oonetloz with this permit and that applicant:' s farm g x9rltts,a at S �I1 a: by:the rules and regulations for permats as butl�ned in the ..... Wzrt:dsor's Street Cut Permit Manual. * * PERMIT 70.$E KT 4N `74�8 ST4 ,ALI TIN1S ..* Issued by Date Completed ----------------- 3n6pect,ed By APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 n FEE $25.00 Name of Firm !z FS� ��� N�= Phone Address of Firm_ Location of proposed work 01),4 P& Describe fully nature of permit requested t?rN-ye Xi u(-- Starting date - 2-C 4 Approx. time for completion 50 y�5 Call Before You Dig No. k) d- Traffic Services Control No. N/`# Show sketch of proposed work or fumish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor Pavement Cut No.cuts 0 Est.Size of Perm. Patch(s) Est. Pvt.Thickness in. Est. Unit Price$ Amt.of Deposit$ Total Due$ by ( )Cash( )Check# Permanent Patch No. Cuts Size of Patch(s) Final Billing Amt. Due Payee Amt. Due Town By Applicant is responsible for contacting Date the Police Dept.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 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 OUTLINED IN THE TOW -OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: c Date: Title:_ �C %I�E'�/ Driver's License#:_ PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES