HomeMy WebLinkAboutDriveway Street Cut Permits 42 Gail Lane 700055 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/21/07
GIS ID: 34500042 '
>,.F..;`. FEE: 25.00
MUNIS APPLICATION# 2007
007 €B PIRATION DATE: OS/2;,; 0/08
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APPLICANT:
NAME: AIROLDI S INC. S ANE
RET,.: IL:~' ,4" A U
ADDRESS: P O BOX 71 wE:>::a `�'
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SOUTH WINDSOR C`I:Cl'' c' LANE
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I�TD O CT 06074
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WORKDES DESCRIPTION: DRI ��
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APPLI
CANT AGREES TO FURNIS
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S0AJ H;' 'HMO..; `^`OF T3" RE�' �;;.. � ,: D�'D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIz: NS :I 1?;fw'm Q Ff ;,1C�IA' TENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THEjPPICAT : S`FT FI ,Nl? II '"ABIDE BY THE RULES AND REGULATIONS
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FOR PERMITS AS OUTLINED IN THE TOWN OF"b.f) I 7 Iti TF I T`CIFT R vII'I MANUAL.
ISSUED BY DACE`°INLD INSPECTED BY
5/21/2007 11:36 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: oo o5 S
. CONTRACTOR: /4 I (e l c4 1 0—
LOCATION:_`4 a, 1 L. N ADDRESS:
TYPE OF WORK: ��
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:_ 13JD
WORK IN
PROGRESS:
.INPUT: DATE:_-- ' ��`
APPLICATION FOR STREET EXCAVATION PERMIT 7 0OD IS Ij
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm -���'� �-�L- Phone No.
Address of Firm >o _QQ �. `1 \ ��,y���sJ'.��i,s�� C 7 c, (;01 {-
Location of proposed work
Describe fully nature of permit requested
Starting date `�-'�c o�1 Approx. time for completion w -
Call Before You Dig No. aa�`�a®� 5 `l 3 Traffic Services Control No.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
0 No.cuts
Est.Size of Perm. Patch(s)
Est. Pvt.Thickness in.
Est. Unit Price$
Amt.of Deposit$
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
PEIRMITSW91%IT,LINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: s\�� "1
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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