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HomeMy WebLinkAboutMiscellaneous Street Cut Permits 733 Gov TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 4012 1co,zltXMt0 MA1;°1*II ;,°IAVTER,O CONTRACTORS Location 0733 GOVERNORS HIGHWA ,Ac ;tessy, ;TE tRI I7,S '<:AVENUE Type Work MISCELLAN 48 I2�QT`,,CT ,6010 :4029 "i,: ;7: ,.'?S: :✓Fi>nY"''.�"::'•fib Date Insp Needed Tim e e Ins H Nee ded d Inspected + y� ns y e Y P `wx "t Y. >tvC: Work in Progress � „ , Input] ..:Date Permit No. 4012 Town of South Windsor, CT Date 06/14/2005 Street Excavation Permit Expiration Date 06/14/2006 "i Descrip: PERMANET PATCH RESTAATI,Of7 , Applicant z' ` bfisea' ion n '�:.. Name MARTIN LAVIERO GfONITPR.XftlCfifiORS 0 � G�? sAN, S 33IG..KWA .>. Addr. 371 TERRYVILLE %AVENU$"".` BRISTOL CT 0601Q'-; 92::9':. WQ"`;!'s Phone (860)589-7579 X. ?r A Applicant agrees ' o f4�#i ;sl thy" i©�vaY i f tikth Wibdsk- the am punt of bond required and to re:imburfe _tELe Town,.m. :.:. ' . � tzadsor c3. r:.>a. y`a;:ecpenses incurred by the Ta3aYs ` br T�taanbe3l33E ' ed wc�xn e0nn�ta'on with this permit and that apli `ant x6. famif"iar vi'it$ aric€ zai7 'aiy the rules and regulations for erMV;t's`a` '.t? P S'cRct 1111d, t'ti ;Windsor s Street Cut Permit Manual. ik Lv * * PERMITT.,.`.;;ONen l'i� AT diI L IIM$;8. Issued b y : Date Completed ___— _---- Yf'Sp'eoted By 0'd/06/2005 DION 0:34 FAX 860 644 7280 South Windsor Tosm Hall 121o0I/pp.�) s APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.04 Name of Firm �� ^-�=-�—' � Phone No. .$��� ' 7S 7/ Address of Firm Location of proposed work Describe fully nature of permit requested Starting date Approx.time for completion Call Before You Dig NoaZ pv p� oc' Traffic Services Control No. 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) IEst.Pvt.Thickness in. Est,Unit Price$ Amt.of Deposit$ Total Due$ by )Cash( )Check# de '" Permanent Patch No. Cuts ` Size of Patch(s) Final Billing Amt.Due Payee Amt.Due Town By Applicant is responsible for conta:ting 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 0 LINER IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.' Signed: Date: Title: Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES 06-06-05 07 :45 RECEIVED FROM:860 644 7280 P . 01 06/08/2005 15:11 FAX 2032486448 CALL BEFORE YOU DIG 14 002 05-0S-0S 1!3:4-6 MARTIN LAVIERO CONTRACTOR ID-$60 5$5 665d 04%( �7 1 1 �1 OAS/u�/ZQU5 13:47 FAX 2UJ248t,446 CALL }3 YUKE: Yl?U 1}1C� 1�0 �6-es-65 12:11 pAYvTIA) 1,AVIrMO CONTRACTOR 11)=860 555 6651 P • 04 CALL 13EF014-E VOU DIG, INC 'F -A-I-OC-4-TE F oRlyl (203) -248-6448 xr LOCATt REQUMTS ONLYWn RtN-1:W s �-•�,�y}���,y �J�� 7�'{� x-� �yT �y�y rx�rx�z;, ��=��nr� C:0pA AN yNA2q_._ MA-RT11M LAVIERC) �d�i'.RACT0 , ADD"SS_ b 1 1 NORTH MAIN STREET/P.o. :RC)X ". CITY:! �3RISTar, _ STAJTj j Zjp Coj)Ra 0 G 0 T 1-7 65.r TEIXMUNE 1�7�r1 i1 � � _ s_ -7 _ M CALL,,- ALTERNATE xT-LMgoNZ DER; sTIM-E7 NEAREST MTrEtSE,GTrgC.ST" RZ': T NT OF FORK. AREA MARKED- �'-' c NO - —(A 1�n UTMIT198 NOTIFIED I� 96-98-05 1:2;58 RgCEI�1Trb FR{�A[: 21�13�'48GA48 Zy.tJ:, 06-08-05 14: 22 RECEIVED FROM:2032486448 P. 02