HomeMy WebLinkAboutDriveway Street Cut Permits 423 Foster R r
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4042 �'• '
COnt'ra"t'torW"QUAlitTY-::,PAVING CO.
Location 0423 FOSTER ROAD
Type Work DRIVEWAY ddre ,�PMAI <:: TREE
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�TWTIaSOR "CT 06088
°Phone No ,r; a;0) 23 >�82`.
Date Insp Needed
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Time Insp Needed s,�
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Inspected By
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Permit No. 4042 Town of South Windsor, CT
Date 07/21/2005 Street Excavation Permit
Expiration Date 07/21/2006 r'0'
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Descrip: CK 4655 - 4 PERMIS *"
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Applicant r Loca`tl
Name QUALITY PAVING CO 3 FOSTER OAD
Addr. 194 S. MAIN STh€EE 'ts3 `"'fr'`s ,
EAST WINDSORT,isO"6088 ux" 5yL' a )S 'Alv$ 7A ':
Phone 8
;l 3
S.
� 6 0)5 2 3 418 2
Applicant agreep "t'ti :iiksY` the
a9 yiu ? OhO. amount of bond
required and to reti0Xs1eT' : s: oit ••, s,or o -ai�� x�l�nses
fi 7u`. i >`'d Y% .'%��% ✓ lik/;;Q;w.l Y,••i"
incurred by the Tovtpr y i
Qna1Yt° or� ^ephi7eril iirinxY'ecton with this
permit and that app1.i'a..t H�� �<� ?" �»p `�`l>`�� Vie."bye Che rules and
regulations ' � ' w�: !"
Street perets a;s 'tliY,ee0� ; :
Cut Permit Manual.
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* * PERMIT ., %a..BFi' $$. Nn: S)I f$:aYE;'7�T �L,S T.S1 S.
Issued by e� .1 ;k
Date Completed Inspected By ____
APPLICATION FOR STREET EXCAVATION PERMIT a yZ
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
n FEE $25.00
Name of Firm -G Phon No
.
Address of Firm (j
c
Location of proposed work L11
Describe fully nature of permit requested
Starting date $f. C7 Approx. time for completion 4,67
Call Before You Dig No, t2- bjW Traffic Services Control No. all
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
Est. Size of Perm. Patch(s)
Est. Pvt.Thickness in.
P
Est. Unit Price$
oL4 j Amt.of Deposit$
U Total Due$ by
( )Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt. Due Payee
Amt. Due Town
By
Applicant is responsible for contacting 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: /`�� �( t-c�r�� Date: 7a5✓
Title: rc- Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES