HomeMy WebLinkAboutGrade and pave driveway Street Cut Permi 6
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PeY�nit No 4329 Con NC.
tractor AIROLDT'S.,I
;A resa
Location SpLI�,H WYNq,OR CT, 06074
Type Work DRIVEWAY
PTnone No:'L8 )2$9 3876
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Date Insp Needed
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Time Insp Needed _ ---,- ms Ixtp
Inspected By
Work in Progress I'*J'
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Permit No. 4329
Date 11/01/2006 Town of South Windsor, CT
Street Excavation Permit
Expiration Date 11/01/2007
Descrip:
Applicant
Location
Name AIROLDI S INC
�517 Addr. ELLINGTCN Pi¢Ap
P O' BOX 71
SOUTH WINDSOR CT A6074
Phone (860)289-3876 e b£ ° DRFiFEbrAY
Applicant agrees: to
e a
ftlhy,5h the Tmxtn t�f Sosh Windr� `thmount of bond
required and to reimbrl`rSe;;: � a;;:=off'.::a�su.t.h'«t:': :rb
incurred by the Town .> ' r. x fir any•eP 'nses
:�� mat� anCe or'repair worl ;; si<<, on .ctibn with t
. .;. h i s
permit and that a lic''a"t PPt :.
r 13a azY w��; a-b1de by`tkf'e rules and
regulations for permits as otgtl;ine ;!.,� e:.rov7.<:of
Cut Permit Manual. axxdsor s Street
PERMIT T 'O SE KfiPT
Issued by
t l'e'
Date Completed
----- — Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT 339
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm C\y,�\\:, s �� .,�
Address of Firm Q y Phone No.
Location of proposed work ��
Describe fully nature of permit requested
Starting date_
Call Before You Dig No. ApProx. time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out b
Town of South Windsor
Pavement Cut
A � No.cuts
_V) Est.Size of Perm.Patch(s)
g'
Est.Pvt.Thickness in.
Est.Unit Price$
Amt.of Deposit$
�o
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 contactin
the Police De t.and C.B.Y.D. Dat
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORKFIN
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMIT TLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:
Title:
Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES