HomeMy WebLinkAboutDriveway Street Cut Permits 40 Foster Ro TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3235 Contractor E.C. PAVING
Location ."zQ4 0, QSTER_ ROAD, Address 139 WETHERELL ST
Type Work DRIVEWAY MANCHESTER CT 06040
Phone No. (860)647-9834
Date Insp Needed CA Date Insp. /y��/
Time Insp Needed � Jme .Insp.
Inspected By
Work in Progress
Input _ ��i _ Date ��
� Permit �No. 3235 Town of South Windsor , CT
Date-�,,- 12/03/2001 - Street Excavation Permit
Expiration Date 12/03/2002
Descrip:
Applicant Location
Name E.C. PAVING "
' W40 FO,STE�,R ROAD
Addr . 139 WETHERELL ST ".
MANCHESTER CT 06040yp�, of �+VcCpRIVEWA�I
Phone (860)647-9834
x v
Applicant agrees tG+ u rn 61j ;the '1Rt�wny
� W�-nbsor the amount of bond
required and to reimb ,rse,°. k � �Townr�;� th Cztsor --for any expenses
incurred by the Town for rat narra C "'M �pair' rprk-wfin connection with this
permit and that app1ioanit ,$ a � anc 11 -abide by the rules and
regulations for permits1;t1t c�W �c�f &mouth Windsor's Street
Cut Permit Manual .
* PERMIT Tb AT -ALL TIMES.
Issued by _ �. S(LNA T" tle 11 P(�o��c� �►A)9-�
--
Date Completed �� �� °�` _ nspected 8y -�,00/,_ , ,
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm G q Phone No. 66 g
Address of Firm e e An 1e,-- '
Location of proposed work yo —o r o
Describe fully nature of permit requested Q
Starting date ""3 —0 1 Approx.time for completion t cJ ee S
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North
Prop.size of cut
No.cuts
Amt.of Deposit$ by
sq OCash OCheck#
l Cut size-after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
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.
Signed �� � Date:
Title: S7�t�inc�7�o(' D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
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