HomeMy WebLinkAboutWater Street Cut Permits 260 Deming Stre TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4122 Contxa'tEor CALDEt"R:A<;:;,CONSTRUCTION'
Location 024 ' �F .STREET
Addres&; 580 FOREST RD
Type Work WXT WEST SUF'F 'ELA. C"F... 06093
P3zone No (861.'}.2`42-'Yi}37
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Date Insp NeededDat
Time
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Permit No. 4122
Date 11/04/2005 Town of South Windsor, CT
Street Excavation Permit
Expiration Date 11/04/2006
Descrip: INSTALL WATER SER .,.,.....,
VICE IT HOUS.E' ><
r.
Applicant .
LacaCo 't
Name CALDEIRA CONSTRUCTION
Addr. 580 FOREST RD ObO DEMING TREF,i;
WEST SUFFIELD Cfi -0603
Phone (860)242-7017 Tie o€ W�srtt tA1' R.,
Applicant agrees to Puna sh the_ downy SoLI3 Winds tkYe arloxnt of bond
required and to re4bur i . the9 ow t ou: 'h.,`'<Al r `"
incurred b theS.:Q;:. E: rryx: 'nses
Y Town:. for maitt6x�ance or- 'repair wor}s lrt conctpon with this
permit and that applicant i�'fati 'xgN� h axc3'will .abzcie.by tke rules and
regulations for permits a .oCrane_:cC} ;. ;? .: 9f S, u. 'h.:T.•'.:Cut Permit Manual, r s Street
* * PERMIT TO BF Kt'PT. O
iJ JOB SITE AT AIL TIMES.
Issued b J
Date Completed ----------------- Inspected B
Y
APPLICATION FOR STREET EXCAVATION PERMIT -4�4!
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00 �� l
Name of Firm e o C'C� OA `� Ov%- - C Phone No. C�
Address of Firm
Location of proposed work P A
Describe fully nature of permit requested
Starting date Approx. time for completion
Call Before You Dig No. f�0 _ Q Q�Traffic Services Control No.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavery Cut
Cet7ts
Est.Size of Perm. Patch(s)
O,e yvk k I Est. Pvt.Thickness 3~ in.
Est. Unit Price$ ,"�S,F•
00
Q t.of Deposit$ Z I o.
Total Due$ Z,I 0. � by
Cash(✓)Check#
1 pit C Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt. Due Payee
Amt. Due Town
By
Applicant is responsible for contacting
(�(�J Date
the Police Dept.and C.B.Y.D.
1 AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR HE 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 OUTLINED IN HET WN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Lhg,17k Date: C�C>�
Title: _ Driver's License#: `,/e r
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES