HomeMy WebLinkAboutDriveway Street Cut Permits 116 Fairview TOWN OF SOUTH WINDSOR INSPECTION _-REPORT
Permit No. 3 Contractor AIROLDI..S ' INC.
Location Address 41 "INFANDEL CIRCLE
Type Work RIV�EWAY TOLLAND CT 06084
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Phone No. (860.)896-0401
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3251 Contractor AIROLDI ' S INC.
Location 0116 FAIRVIEW DRIVE Address 41 ZINFANDEL CIRCLE
Type Work DRIVEWAY TOLLAND CT 06084
Phone No. (860)896-0401
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• 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. 2qcl 3$1 C
Address of Firm v
Location of proposed work
Describe fully nature of permit requested
Starting date D Approx.time for completion a—
Call Before You Dig No. ZOOS Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawi
Pavement Cut
Indicate North Prop. size of cut
No. cuts
Amt. of Deposit$ by
()Cash( )Check#
Cut size after Perm. Patch
No. Cuts
Final Billing $
Amt. Due Payee$
Amt. Due Town $
ANNiicant is responsible fvr conta%ifiiig by Aa`
the Police Dept. and C.B.Y.D.
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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 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
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
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Signed: Date:
Title: ��O"'�$�d D.L.#:
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc