HomeMy WebLinkAboutDriveway Street Cut Permits 972 Chapel R TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No Cont.ra&t'or ADVANCE
Location Add:res 3 BRGALI.STRE'E,.T
Type Work DRIVEWAY . 0
A :CHESTE.R; CT.;. "'6;;040
done Tto (86Q: 6$54.4163
Date Insp Needed --------- Date Iias:p fit ` _
Time Insp Needed °M
Tuna Iris
Inspected By —
Work in Progress _-A.
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Permit No. 4258 Town of South Windsor, CT
Date 07/25/2006 Street Excavation Permit
Expiration Date 07/25/2007
Descrip: TO REPLACE AND REP;k` `DkIV :WAY"
Applicant Location
Name ADVANCE O572 CHAPEL CAD
Addr. 3 BROAD STREET
MANCHESTER CT ObQ40 Iy � DFZTVEWAY
Phone (860)655-4163
Applicant agrees, to ftit n ekL the •r i a ref pL1t;11 Wind�6. the'<at�ount of bond
required and to r "
4 e i Ca}tirs e'>: '
eases
incurred by the Town fzsr iettegance' or repair' Woriznyoi2ne.gtitin with this
permit
;.. . ..., : s tandthat aPPcan ri � by e rules and
regulations for permi .s as otiti'ined iii the. qw�f of SouG'n V�maci3'or's Street
Cut Permit Manual.
* * PERMIT TO "8:E KEPT;ON"" {3B..:' i1>T '`]1T,.:.. Z :TIM. S.
Issu
ed b
UV�1 I t
y ---- n- `l./ t 1,�
Date Completed __—_-- Inspected By "
APPLICATION FOR STREET EXCAVATION. PERMIT .
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm
Address of Firm Phone N .
Location of proposed work C
Describe ful y nature of permitlequested �.
lac �• Y �, �r-iv
Starting date
Call Before You Dig No. Approx. time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out b
Town of South'Windsor
Pavement Cut
No.cuts
Est.Size of Penn.Patch(s)
Est.Pvt.Thickness in.
' P
Est.Unit Price$— /
Amt.of Deposit$
i
Total Due$ by ..
)Cash( )Check# .
Permanent Patch
No. Cuts
`Q
Size of Patch(s)
Final Billing
Amt.Due Payee
Amt.Due Town
1 By
Applicant is responsible for contacting
the Police De t,and C.B.Y.D.
1 AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
TOWN OF SOUTH WINDSOR 0 ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION THIS P THE
PERMITS AS T ED I AN HAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
,SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:
Date:
Title:
Driver's License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
fl L 97 Z- CA<Pe",
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