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Home My WebLink AboutDriveway Street Cut Permits 385 Foster R 4 APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR Amt. Bond Required PUBLIC WORKS DEPARTMENT Amt. on File a-Go TOWN HALL Permit Me Date of Expiration N-4 1540 SULLIVAN AVENUE Date Ins. on File (Ao*fs ( ) No SOUTH WINDSOR, CT Permit Expires Expiration Date jq -9 7 FEE $25.00 Name of Firm `v Y co Cn Address of Firm �a CX. Phone No. (- Location of proposed work } Describe fully nature of permit requested Starting date Approx. time for completion { Call before you dig No. r Traffic Services Control No. Show sketch of proposed work or fu ish To be idled out by Town of South M mdwr two copies of separate drawing O Pavement Cut Indicate North Y Prop, size of cut No. cuts Amt. of Deposit $ by ( } Cash O Check # Cut size after Perm Patch No. Cuts Final Billing $ --- -- - -- - Amt. Due Payee $ — Amt. Due Town $ Applicant is responsible for contacting the Police Dept. and C.S.Y.D. by date I agree to funish 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 ma' tenance or repair work in connection with this permit and that I am famil' r wi an will abide t e rules and gulati ermits as outlined in the Town of South Windsor's Street Cut Permit Manual. Signed:_ ,✓^+.� .ale: D.L.L.# � Date: 1 PEfVAIT SR4LL BE lam"T ON JOBSfTE AT ALL TIMESMOM APPROVED: 5 171 DATE: TOWN ENGINEER FOR INSPECTOR: Date work started Date Completed Signed Date WHITE - PERMIT PINK - ST. SERVICES -- -YELLOW ENGINEERING '° GOLDENROD - FINANCE -4030 Columbia ASPHALT 870-8983 Tolland COMMERCIAL-RESIDENTIAL JOB ESTIMATE BOIVIN CONSTRUCTION CO. INC. Date of Estimate P.O. BOX 337 COLUMBIA,CT. 66237 Prepared By Estimate for: Jew- ( Job Address �J 68�✓�Q� d6Dd Work Phone Job Phone Specifications: av \ regrade using existing base. �►L� a rocessed stone as follows: 0"-2' 2"-4" 4' -6" other cle oC311" of pave usin class two asphalt prior to ction i Estimated Completion Dated L State Permit Required yes no ...... Town Permit Required yes no Taxable yes no ESTIMATE APPROVED BY Signature Approval This i a-4030 Columbia ASPHALT 870-8983 Tolland COMMERCIAL-RESIDENTIAL � JOB ESTIMATE BOIVIN CONSTRUCTION CO, INC. Date of Estimate P.O. BOX 337 COLUMBIA,CT. 06237 Po Prepared By Estimate for: /�j n� Job Address age Work Phone Job Phone �( V66 o Specifications: A26 6 \ regrade using existing base. a rocessed stone as follows: i11eX 21'-4" 4 —611 other le on pave usin 3111" of class two asphalt prior to c action 1 W Estimated Completion Date State Permit Required yes _. no- Town Permit Required yes no Taxable yes no 1� ESTIMATE APPROVED BY Signature Appro= _ This ^- tT t APPLICATLQN. 'f =SET 'k`�AVATION PERMIT TOW ;pUT. : WINDSQR �Amt. Bond Required PUBt�(C 5 PARTMENT Amt. on File V0. H LL Permit Date: of Expirationt�lly"�.7 1540 S .f :L VAN AVENUE Date Ins. on File (�s O No SOUl"H WIND ORS CT Permit Expires , Expiratiori Date of-�'7 I= E . 2. ro0 Name of Firm Address of Finn r Phone No. Location of proposed work Ckyr� _ �._NA , Describe fully nature of permit requested Starting date Approx. time for completion Call before you dig No. Traffic Services Control No. Tj cn Shp* sketch of proposed work or fu ish To be ffed out by Town of 9crdh tfilindsoP two copies of separate drawing Pavement Cut Indicate North' Prop. size of cut 1,9 No. cuts i Amt. of Deposit $ by OCash { ) Check # `mow Cut size after Perm Patch No. Cuts r., ..•' Final Billing $ Amt. Due Payee $ *Y ` Amt. Due Town $ _ Applicant is responsible for contacting --the Police Dept. and C.B.Y.D. by date I agree to funish 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 ma' tena or repair work in connection with this permit and that I am famil' wi` an will abide th ules and gir ti ermits as outlined in the Town of South Windsor's Street Cut Permit Manual Signed: n t tle: r ( . D.L.L.# �.✓V � Date: PERM r SHALL BE ITT ON JOSSITE AT ALL T1WS r ` ,tkp APPROVED: /A'*I F"`A'tAdw DATE: �-2�-- �4 TOWN ENGINEER FOR INSPECTOR: Date work started Date Completed Signed Date WHITE PERMIT PINK - ST. SERVICES YELLOW"" ENGINEERING GOLDENROD - FINANCE