HomeMy WebLinkAboutDriveway Street Cut Permits 261 Foster S ti
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4087 Cor1.t'rA*bto,r..M&S PAVINGAND SEALING, INC
Location O261 FOSTER STREET AEidresa 435 $UC�LAND >�OAD
Type Work DRIVEWAY 9t)UTH WIN155OR CT::.,,06074
Phone No, (BE��Yfi48 1915 ::
Date Insp Needed Date Tiisp
r
Time Insp Needed --------- xm� Itsp
Inspected By
Work in Progress
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Date I�aC6
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Permit No, 4087 Town of South Windsor, CT
Date 09/20/2005 Street Excavation Permit
Expiration Date 09/20/2006
Descrip:
Applicant LaCat1C}11
r :y
Name M&S PAVING AND SEALING TNC 061 FOSTER Sx2EET
Addr. 435' BUCKLAND ROAD
SOUTH WINDSOR q"s 0. 074 �ype 'o� 6¢G3 �C F3FtF�TLWAY "
Phone (860)648-1915 "
Applicant agrees to ftlxffi.s.h the SCSiftl Windsor the amount of bond
required and to reimburse the Tdwr�' % �SuCh $f ?#xsor frr;an, epnses
incurred by the Towns for maA0 dnanci§ tar, repajr :WV 3n mnnt;cti n with this
permit and that appl%cant is';>< 'ati '1>i>"' z« r >: :: ::`> ; :... :', .k, ;;
:,..'� abide by tkze rules and
regulations for permits as: out�.ind'Si xhe Tsw .<�' gp :n q�„ Dcl 'or's Street
Cut Permit Manual. .:
* * PERMIT
TO 'BE KEPT ON' ilo,{� �IT:E �YT ALI, TIMES.
Issued by /L
l�
O l
Date Completed _----- Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm Ij f iQ-N'?� (S !N6 /Ai L, ($Zc�� U q
Phone No.
Address of Firm'f 3.5 gaCk_ .4w,6
Location of proposed work
Describe fully nature of Permit requested _R E('n oye AfVD be i is W -q
Starting date Approx.time for completion _ bA4-'f S
Call Before You Dig No. �?ot7S'��U U 7$U' Traffic Services Control No.
Show sketch of proposed work or famish _
� of use M - Indicate North Th s o he
TOM of South i
Pavement Cutts No.cu
Est.Size of Perm.Patch(s)
Est Pvt Thickness In.
tvi
Est Unit Price$
Amt of Deposit$
Total Due$ by
( )Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
Final Bing
$
AmL Due Payee
$
Amt.Due Town
$
By
ApPIcant is resPonslNe for contacft Date
the Poke Dept and C.B.Y.O.
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 OUTLINED IN THE T OF sCK WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: 0, Date:
Title: Driver's License#
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