HomeMy WebLinkAboutDriveway Street Cut Permits 915 Chapel R 1 f
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3670 Con tracvt,ar::.,•:A:YY:. SCONSTRUCTION, INC.
Location q'S Cho�pCl Adsess,. :;:P O I3•RAWEF�'aS
Type Work DRIVEWAY ;y<:
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Permit No. 3670 Town of South Windsor, CT
Date 04/13/2004 Street Excavation Permit
•
Expiration Date 04/13/2005
Descrip•
Applicant
Locaztion
Name A.F.S. CONSTRUCTION
:
Addr. P O DRAWER S
EAST GRANBY CT St6026 :.�"��'"k�....:p Wor`F
Phone ( ) f
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Applicant a ree tsfurii� $Y the
I swYy j ikth W 'a-Q'ara� tie amount of bond
required and to rexmbur'se t1iown`of ScStf ',;id� dsorar a: expejises
Mir i
incurred by the Tovan for maztQnan�e ore cork irrn3�eeicn with this
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permit and that applicant:' s`rf m% � .:a ii%a l: ::''tl'e >b ' :the rules ules and
regulations for peri'ts as ftaned in the Town of 6ou #� Widsc'r s Street
Cut t Manual.
Perms ..:a:•�tfy;s«.a„.:l:r�,
PERMIT` O $E.+K :T...:0�Y'':� 3'
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Issued byxtle
Date Completed Y a
APPLICATION FOR STREET EXCAVATION PERMIT 3l1
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm_ �T�� ��7 mac_ Phone No. oovJ�3�G �
Address of Firm_ p Aox 5y
Location of proposed work
Describe fully nature of permit requested vase-
Starting date -Iz-04 Approx. time for completion
Call Before You Dig No. /lf 1#4- Traffic Services Control No. 4)
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
Est.Size of Perm.Patch(s)
Est. Pvt.Thickness in.
Est. Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt. Due Payee
Amt. Due Town
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 TOWN SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: _`2 Q
Date:
Title: L l Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES