HomeMy WebLinkAboutMiscellaneous Street Cut Permits 76 Gail TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4219 Contr..a.e>td"r `CK' f:OftT.RUCTION
Location 0076 GAIL LANE PcTres ;, '':::$2 N.T> 'ES.:;;RO1D..,,
Type Work MISCELLAN ppgUONOCK.,,: .T 06'0:44
Phony ' 10 (8'Fz1)242 ''4999
Date Insp Needed
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Time Insp Needed �Jj —C�(��� mxme <IiiE� r
Inspected By /r
Work in Progress _—_------
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Inu ---- Date'
Permit No. 4219 Town of South Windsor, CT
Date O5/10/2006 Street Excavation Permit
Expiration Date 05/10/2007
Descrip: REPLACE CONCRETE SI,DEW ? >:>:"';:< .< <....'`;:(";«..,.
Applicant
LoCat'son
Name CK CONSTRUCTION 0'0�6 GAIL LART ,
Addr. 82 NILES ROAD
POQUONOCK CT 06064. yz of ;� MISCETTAN
Phone (860)242-4999
Applicant agrees to fuXTi s}a .the Tovan ks South Wind o W6 amount of bond
required and to reititbtSiSe the, oc0uxt�u•th irizdsr frr anyenses
incurred by the Town .fq.r mx�ld7:tezlanc'e or repair 'wc5rk i'�,' Cz�Anecticyn with this
permit and that a lr;carit i'....... . .:..::::::><< „:?>:.>.:,,'::
pp s atUT: ri` i att w�11 ,abide by the rules and
regulations for permiC6 as oikt lned::.i ttae TAwxY of South Wi ndsor s Street
Cut Permit Manual.
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* * PERMIT TO B. K4PT ON dOS SIDE' AT �1LT, '2IMES.
i
Issued by
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT 411
' TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm C.
Address of Firm Phone No. y� J�c�
noc a
Location of proposed work
V-
�ni L
Describe fully nature of permit requested �
�... c )
Starting date . -
Approx. time for completion
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out by
Town of South'.Windsor
Pavement Cut
No.cuts
Est.Size of Perm.Patch(s)
Fir �"7& t Est.PvL Thickness in.
�d�re�
Est.Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check# .
Permanent Patch
No. Cuts
Size of Patch(s)
X I X A Final Billing
----- Amt.Due Payee
Amt.Due Town
By
Applicant is re no nsible for contacting
the Police De t.and C.B.Y.D. Date
1 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 _ -OUTLIN `D IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: —
Date:_
Title:_- Driver's License#* -70
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES