HomeMy WebLinkAboutDriveway Street Cut Permits 19 Dart Hill TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3758 Cora::t>r'actor A.F."9.:':G.RNSTRUCTION, INC.
,Location 0019 DART HILL ROAD Address P O
�1R P .
MR-S.
Type Work DRIVEWAY EASE GRAMBY.:CT::::06026
Date Insp Needed _—_----- bate•'3n p
Time Insp Needed
-�Inspected By
Work in Progress r
--------- Input. : �J►•`. Date —��1��0 --
f
Permit No. 3758 Town of South Windsor, CT
Date 06/14/2004 Street Excavation Permit
Expiration Date 06/14/2005XX
Descrip:
Applicant LOCB't. on
Name A.F.S. CONS TRUCSION ' INC. Qk79 DART H?L...L READ
Addr. P O DRAWER S
EAST GRANBY CT 06.Q26 Tie A G77otk,+DRTV9WA'-
Phone (860)653-6083
Applicant agrees to furrii:sh the Ttawss t� Stz'Ch Windsor ,the amount of bond
required and to reimburse the Totttk<bo,uthtt#�3sor for airy e�cpnses
incurred by the Towh for max3itanahCe or'�epair' worm :'yam ccnnectron with this
permit and that appl,i� i7t a s<f, rrral: a th 'AU `:will :�bicle;,:by the rules and
regulations for permits as outlineein tine To :n of South 'b, ndSor s Street
Cut Permit Manual
* * PERMIT TO BE..!'&"EPT OhT ..............S2TE 'AT ALL... TIMES.
X.
+�
Issued by
Date Completed _-- Inspected By
----------
APPLICATION FOR STREET EXCAVATION PERMIT .377.�--y
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm �� zfi/G Ali, Phone No. 860 6153 60813
Address of Firm )C v
NAY" G7" r,&e0Z
Location of proposed work_ / }Rj f�ILG 'l�
Describe fully nature of permit requested a✓ i9-ue� 167- 6' -L'Wjtle
Starting date Approx. time for completion
Call Before You Dig No. Traffic Services Control No. N
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
Ij iq
Est.Size of Perm. Patch(s)
Est. Pvt.Thickness in.
Est. Unit Price$
t
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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: D
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES