HomeMy WebLinkAboutDriveway Street Cut Permits 107 Dart Hil (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4128 contraCtor .TBFFREY 2ULL
Location -0107 DART,HIT,, POAD Addres %A
Type Work DRIVEWAY SOFaIH WIN $OR b:T- 06074
Phone RQ
Date Insp Needed date Ii ' M.
Time Insp Needed Attie
Inspected By
Work in Progress
Input' '- Date
Permit No. 4128 Town of South Windsor, CT
Date 11/18/2005 Street Excavation Permit
Expiration Date 11/18/2006
Descrip:
Applicant,;::?
lican ts`?`
Q:Cat ..On
Name JEFFREY KRULL ' O10"i"nART HSLL RC3AU
Addr. 44 ELM STREET : ,
SOUTH WINDS
C Q6fl?$; rlrye !; y A7ork W.R3VEWAY
Phone
Applicant agrees tourpzh, the Town ci# S.Quth Wzndspr ,t'he,>agtount of bond
required and to reimburse,'the Teian q Sox 1 nd or, fo:r, an,, expenses
incurred by the Town for ra�ntenance' or repair 'woYk in Connecl'ion with this
permit and that appliCarit :zs fanzl3ar yea G :end wz. l abide ;by;the rules and
regulations for perm4,ts a outlined 'xsY the Town cj.f Soot Atzridsor's Street
Cut Permit Manual.
* * PERMIT TO''>,,SE:'rKF;P:TQN`"JFSBs'sI"1 ,AT.'"Z1LF'T >MES.
Issued b . ' Titlp
Date Completed Inspected By
t
r
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm- J, T 4. 12Jt4 CcerS`T Co Phone No.
Address of Firm 9V c2,-1 57--
Location of proposed work_ 10? 46
Describe fully nature of permit requested �4tJ4 �iyZf✓
Starting date Approx. time for completion
Call Before You Dig No. 2 0-0 5 4 6Ga ?Z'] Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
CJ
Est.Size of Perm. Patch(s)
p �j�
Est. Pvt.Thickness in.
Est. Unit Price$
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 TT IN�E TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: /A
Tit' 6UtJ � Driver's License#: 6 5-31
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES