HomeMy WebLinkAboutDriveway Street Cut Permits 160 Dart Hil TOWN OF SOUTH WINDSOR INSPECTION REPORT
hermit N 4 Contxadtor AIROLbT*S;,INC.
Location
.F�c�dressR P O &0X,,71
Type Work DRIVEW= "•
$O[I.TFJ WIND,$O4-. CT,,:,: 06074
P`ho�e TIQ (86A3,2808::76
Date Insp Needed ----_—_--- Dare �ns �
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Time Insp Needed
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Permit No. 4314 Town of South Windsor, CT
Date 10/17/2006 Street Excavation Permit
Expiration Date 10/17/2007
Descrip: REPAVE DRIVEWAY
Applicant Locatro
Name AIROLDI'S INC. 0160,,DART H1.LL $F3�yD„
Addr. P O BOX 71
h
SOUTH WINDSOR CT ff6094 I e o'f for ID.RI.Vz .
Phone (860)289-3876
rn..: • .'
..� pth;. Wind::::agrees. t . g nt of
bond
required and to re*
cy113urse 'tYye Towt1 'youth kJah car for`arty x,.p s
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incurred by the Tow . f'f r ntal.}l,to ance or` re <
,; . pair woxk ovnneCti:on with this
permit and that applxicaiit i fain}gsz w'i.3l ,abicle,by the rules and
regulations for permits as o�atl:inet zsi pf Sut'h Wzrdsor's Street
Cut Permit Manual.
* * PERMIT TO'"S:E'''K 'P "':;ON' O$:+.°. I?'La'""'A.
Issued b
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Date Completed — Inspected By _=
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm C\�� � s —�N C .
Phone No.
Address of Firm .o _ �o y. `1\ O
Location of proposed work o `�
Describe fully nature of permit requested
Starting date \o "ao ob Approx. time for completion
Call Before You Dig No. -]4- Traffic Services Control No,
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out by
Town of South Windsor
Pavement Cut
No. cuts
Est. Size of Perm. Patch(s)
Cow-'t��•z
Est. Pvt.Thickness in.
Est. Unit Price$
J+9, 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
PERMI1 A TLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
Title: Driver's License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES