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HomeMy WebLinkAboutDriveway Street Cut Permits 350 Deming S TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. Cont:raotor QUALT'TY PAVING CO. Location Addres$ 19�} A7AIIT">;$TREET Type Work DRIVEWAY EAST W'INIYSQR CT 06088 Phony': No f8: 0}52 4�82'.: .. Date Insp Needed 3iDati ;S p 4, Time Insp Needed —'�—.—�—(� lt Inspected By I"�1'tiad? Work in Progress ; � — Date Permit No. 3749 Town of South Windsor, CT Date 06/07/2004 Street Excavation Permit Expiration Date 06/07/2005 Descri p: CK 3762 $75.00 3 FE'RM'TTS Applicant LQcat 'pn Name QUALITY PAVING CO. d50 DEMING STREET`' Addr. 194 S. MAIN STREET:>,,. EAST Wj. INDSOR CT Q6088 T?pe f " ofk;D1TV8W y Phone (860)523-4182 Applicant agrees to`,furni h the TcSwn of nU , Windsor the �mpunt of bond required and to reimburse the..Tory .:c youth WardsortSY ariy expenses incurred by the Tow2 zar nraante�anc or repair''werk, ix� cahnecti'on with this permit and that app4o-ds1t xs.:famxl9'a w h dzzd`wzgJ abzde :by the rules and regulations for permits as ©ut3inedxi, teoisxx of SoughI. pdsor's Street Cut Permit Manual. * * PERMIT TO BE 'K:EPT TS$ kT A ;, TIMES. Issued by Date Completed Inspected B r `,7 11UN VUK STREET EXCAVATION PERMIT 7 9 ' TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm f Address of Firm ��� phone No. Location of proposed work LJ Describe fully nature of permit requested Starting date Call Before You Dig N Approx.time for completion Traffic Services Control No. Show sketch of proposed work or fumish 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) - Est.PvL Thickness in. Est.Unit Price7f $ C (I')' Amt.of Deposit$ r . Total Due$ by i ( )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 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 OUTLINED IN THE TOWNPF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: i Title:__ Driver's License PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES