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HomeMy WebLinkAboutDriveway Street Cut Permits 479 Clark St A �► TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 4077 Con or .QUALITY`;:R ,VING CO. Location 0479 CLARK STREET „Ar'dres,s'.!:: .>'194 ;WAIN'"STREET Type Work DRIVEWAY EAST WTNDu'OR CT•,..;06088 Phone No (86#k}52:3 4182 •. Date Insp Needed _—_---�— Date' Time Insp Neededme;I Inspected By : Work in Progress � �t { 77 Ba 'e,: Permit No. 4077 Town of South Windsor, CT Date 09/12/2005 Street Excavation Permit Expiration Date 09/12/2006 Descrip: Applicant Locatjo 2 Name QUALITY PAVING CO. p4179. CLARK S rRFsET >: Addr. 194 S. MAIN STREET EAST WINDSOR C Q60838 Tyke df ic�or]s B IVETAY. Phone (860)523-4182 Applicant agrees to furxixsxi the Towp '�f Cf h Windsor :tlje amo:nt of bond required and to reimb'ur eUrtt3e:;;::: o "`»:`>"''<ar " I bb ,..;S:Qut'3i:,'F35:ox,:f.sr; an' xpes�ses incurred by the Town form �a t'elaance or'repair worlzn cor�neG.tidn with this permit and tha t a PPl is '�:., 'h S by £ki"e rules and regulations for permit':s as 2.a.c; tne* z�a th£. ©tea of Scut ,W�. dsor s Street Cut Permit Manual. * * PERMIT TO BE 'Y$P] .ON'P':Jb$ iS; .FE^'4T ...ATIc:r:TTMFS. r Issued b Y l :Ti t l' Date Completed Inspected By ��_A_— c APPLICATION FOR STREET EXCAVATION PERMIT f'I D 7 7 ` TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 e Name of Firm Phone No. Address of Firm Jr` ' Location of proposed work 42 Describe Ily nature of permit requested i" Starting date_ 'd G 5 zS o0 Z:75' Approx. time for completion �z G Call Before You Dig No. 2oa Traffic Services Control No. Show sketch of proposed work or fumish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor Pavement Cut No.cuts 0 Est.Size of Perm. Patch(s) Est. Pvt.Thickness in. y A� Est. Unit Price$ 2 X) Amt.of Deposit$ Total Due$ by )Cash( )Check# j I Permanent Patch 1 Z No. Cuts Size of Patch(s) t Final Billing $ v Amt. Due Payee Amt. Due Town By Applicant is responsible for contacting 1 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 A UTLINED Ir%THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: A��Z� Date: �//2'/0_5 Title: ��.� Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES