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HomeMy WebLinkAboutSidewalk Street Cut Permits Deming Stree TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3855 Contr-at CONTRACTING Location v� Yciclze5ai Type Work MISCFAN 2 :8IAIP7 ^sir a 11l /� , -W A�-�ry�. D�94-1N CT'06111:. P,.hone :Na. Date Insp Needed ------------ Date Irish Time Insp Needed ------------- � � me IssS Inspected Byz-- ------- !p - ...- Work in Progress ' g -----`-- � - I K - - Input L Permit No. 3855 Town of South Windsor, CT Date 09/21/2004 Street Excavation Permit Expiration Date 09/21/2005 DescriP: EXCAVATE TO INSTALI SID ,O. "EWALK>F:ROT�;< ;5ARANDVIEW.,DOWU%,DEMING ST i ` 'I�oIl A lica nt ova Pp : .t ;. ': 4 Name JENNINGS GENERAL CONt$-A T.At Addr. RORIN JENNINGS NEWINGTON CT 06111 T tl T^Ibr M�.SCELAN Phone (860)528-2329 Applicant agrees to fitrna3Yi'the Town �yf4t „Winder .tLe a4ito4xnt of bon d su. :h" r.,:£`za '`ran:Y > penses required and to reiml�ur:se:i'�hew-';S;o �...,:::.,„.:,:::;: i with th is s i"n wit t Q or;: Tea:ar`>wo'rk.;;':�.n .� ,n .��.. wry: a �. P incurred by the To „ � ,,�, ,�#.; -: ':Y1t ;.... .'7ii . ?`<3X>rY::>&: ;<.<id'i:7:-3:i..:' 'it :bytk e rules and permit and that applic s regulations for permits as gtliner2; tk3NLS of SStuth Wa 'dor's Street Cut Permit Manual. 1� * * PERMIT TO ' Kt- T ON""art)8::,'-g:Z:IgE l"AT,::,,A-1FU>TT'ME'S. i s Issued by t >:. s Date Completed Inspected By fviv rUK 5 I KEET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR `s`� Permit No.PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 --� FEE $25.00 Name of Firm Phone No. !��j�- � �,.�,L Address of Firm ,��� s ev 6l Location of proposed workk� ti S� Describe fully nature of permit requested oor Starting date �Z/ 6 Call Before You Dig No. D©t(-?2 a f y Approx.time for completion zlbv Traffic Services Control No. Show sketch of proposed work or famish two copies of separate drawing Indicate NorthO This section to be filled out by Town of South wndsor T/ Pavement Cut No.cuts Est.Size of Perm.Patch(s) Est.Pvt.Thickness in. Est:Unit Price$ 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 the Police Dept.and C.B.Y.D. Date 1 AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSO FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS P RMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS O�VUNED lTrHE.TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: 2 d Title: Driver's License M. /,2 y Z PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES