HomeMy WebLinkAboutDriveway Street Cut Permits 2469 Ellingt Permit No. 3933 t ---+ Town of South Windsor, CT
j Date 04/13/2005 ""` g <e. Street Excavation Permit
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Expiration Date 04/15/2006
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Name AIROLDI'S INC. LINGT;QIj«., :pAD
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Addr. P O BOX 71
SOUTH WINDSOR .�T O"5(}`T�,,.
Phon 860 e 289-3876
Aunt a ree' fu' is+lYWinso.x >°h.a"'amount of bond
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incurred by the Town '`f.Gzx. ma`.!!£. xi : :::P nx ::»vt r'k<• 11._: nririe t on with this
that permit and applicant #.s ` :oft� : ': sYi:`>.z ':< rY+l" 3a -ds by Ehe rules and
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regulations for per mitss::.out'3inec�:`'a ''C ;:.';,. `of { c�izt; ::_.NTin:clsor's Street
Cut Permit Manual.
* * PERMIT TO'}{BE`T<ET QALt> (.OB..ASITE:.<,A"P''1Lli'"T;IrTNES.
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Issued by ---- ------- --------- -- �awc {{--------------------
Date Completed --------------- Inspected By
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
ermit No. 3933 &3h ra:ctqr AI�O.IDI'"S< INC.
Location 2469 ELLINGTON ROAD
Type Work DRIVEWAY "
t.WIN S R CT.. 06074
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Inpu'�><.r_:.<.r:.:... _:,.�•� Date
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm �� \� Phone No. 1 ` ' Lp
Address of Firm r r �,. -�
Location of proposed wo i
Describe fully nature of permit requested
Starting date Approx.time for completion_Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be fillted by Sout
two copies of separate drawing out Town of h Windsor
Pavement ut
Indicate North Prop. size of cut
+�.s
No. cuts
Amt.of Deposit$ by
()Cash(}Check#
Cut size after Perm. Patch
C 3 No. Cuts
Final Billing$
C i Amt. Due Payee$
Amt. Due Town$
Applica is responsible fcoatactng �� by
the Poli a . and C.B. 1 date
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 IXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS
PER AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: C f/�
_ Date:_ �l ( �J
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PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
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From: <CalICenter@CBYD.com>
To: <cbyd@southwindsor.org>
Date: 4/9/05 11:26AM
Subject: Locate Request-20051600019
(CALL BEFORE YOU DIG -CT) 04/09/2005 11:21:55
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-OT 2-SW SWINDS -T5
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*** REMOTE BATCH ENTRY***
*****ROUTINE **'t**
TIME..11:21 DATE..04/09/2005
REQUEST No...20051600019
LATITUDE..41.8438625 LONGITUDE..-72.5294952
TOWN......SOUTH WINDSOR
ADDRESS...2469
STREET....ELLINGTON RD
NEAREST
CROSS STREET..DENONSHIRE DRIVE
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TYPE OF WORK.....PAVING DRIVEWAY
AREA IS MARKED...YES
REMARKS:
PAVING DRIVEWAY FROM ROAD TO HOUSE
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START DATE......04/15/2005 START TIME..08:00
CALLER..........LU-ANN HORN
CALL BACK.......8-5
PHONE#.........860-896-0401
FAX#...........NO
ALT. PHONE#....
EMAIL ADDRESS...
CONTRACTOR......AIROLDI'S INC
ADDRESS.........PO BOX 71
CITY............SOUTH WINDSOR
STATE...........CT
ZIP.............06074
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EXCAVATOR DOING WORK..AIROLDI'S INC
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY: