HomeMy WebLinkAboutMiscellaneous Street Cut Permits 381 Fos TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2916 Contractor GERBER CONSTRUCTION CO
Location 0381 FOSTER STREET Address 616 DART HILL ROAD
Type Work MISCELLAN
VERNON CT 06066
'Phone No. (860)876-6684
Date Insp Needed 2� "1 � P<< '� wN "' ��� Date Insp: 4- 4 00
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Time Insp Needed Time
Inspected By
Work in Progress ;;'td, �
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Input Date ` -Zo -
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Nerrtil t Nti. 2916 Date Town of South Windsor, CT
02/02/2000 r-Street Excavation Permit
Expiration Date 02/01/2001
Descrip: REPAIR SIDEWALK
Applicant Location
Name GERBER CONSTRUCTION 06 m l FOSTER STREET
Addr. 616 DART HILL ROAD
VERNON CT 06066 7
Phone �860)875-6684 , ry�e .,�f Work MISCELLAN
App1 icant agrees to -fur ;is#� the l"owh b ` St�uth` .W=indsor the amount of bond
required and to reimbur��e � ,fiot�n .oF �Q;�tth SW�ndsor for" any expenses
incurred by the Town ,f 1 r� �f7tena► ce a ,-C epa w ► k` in connection with this
permit and that applicant is f,�� r wi't ,. and 4111 , abide by the rules and
regulations for permits. as,:dutl r tl`;;=:y t� the Jow a Cut Permit Manual . ;Qf South Windsor 's Street
* * PERMIT TO BE KEPT C7 J' ',08 SITE AT ALL TIMES.
Issued by
--- TitleAFC ;
Date Completed 4114�� inspected By _3- �
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT .
TOWN HALL
1540 SULLIVAN AVENUE
- SOUTH WINDSOR, CT
FEE $2S.00
// _)) 1 cc
Name of Firm I YJeT vi T. Phone.No.
Address of Firm-6 tK L
Location of proposed work
Describe fully nature
nat e of
permit r nested
/ 4 W
Starting date 577 Zv Approx.time for completion
Call Before You Dig No. a,WQoco io 6 Traffic Services Control No.
Show sketch of proposed work or furnish To:be filled-out by Town of South Windsor
two copies of separate drawing
PavementCut
Indicate North Prop.size of cut
s��P No.cuts
Amt.of Deposit$ by
O Cash O Check#
fr Cut size after Perm. Patch
No. Cuts
Final Billing$
Alf Tu-e ay.de$,.-r
Amt. Due Town-
Applicant is responsible for contacting by date
the Police Dept. and C.B.Y.D.
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.
f�U.
Signed: l� Date:
Title: / /' ��� D.L.#•
PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES
_ Standard Forms\Permits\Street Excavation Permt.doc .