HomeMy WebLinkAboutDriveway Street Cut Permits 230 Graham R TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3817 ,<,X ..,.>....
Location 0230 GRAHAM ROAD Contra AI22OTr)I,!.,S INC.
Address P O B 71':,;,
Type Work DRIVEWAY
QUTH'"'WIIIDSOR`=CT 06074
Phone No ($60)20`-3876.,
Date Insp Needed
--------- — Date
Time Insp Needed
---------- Tzme ins
Inspected By —fir
Work in Progress
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Input
Permit No. 3817 Town of South Windsor, CT
' Date 08/04/2004 Street Excavation Permit
Expiration Date 08/04/2005
Descrip:
Applicant Ioction
Name AIROLDI'S INC. flQ GRAHAM :ROAD
Addr. P O BOX 71
SOUTH WINDSOR CT Q,6074 � cif Wc�r1c DRIVEWAY
Phone (860)289-3876 ,
Applicant agrees to fur: _ th .Town ci% 'f South Wi�d'ZOr fihe amount of bond
required and to rimbur'se the. Town pf SoU' h 1��Indsorgr aiy eispenses
incurred by the Town toilma enanc or rer�kx :Rork 'gin conn.ecton with this
permit and that ap�lic,.ant. is ifamils;ar' wfth an ;*aa11 abide ;by the rules and
regulations for permks as ouI�nedanh:etawn;: z7f So.utl W `nds'or's Street
Cut Permit Manual.
* * PERMIT. FCEPT A-T ALL„'TIMES:
Issued by
Title
Date Completed s:p:et't'ed By �i
APPLICATIONFOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
15 SULLIVANVENUE
SOUTH IS , CT
FEE $25A10
Name of Firm���o���� -� Phone No._�g,�
Address of Firm -��o•, ����� _ "��\��-�- �� ��"`�
Location of proposed work
Describe fully nature of permit requested -
Starting date�'�,��� - Approx.time for completion. s\�'� .�
Call Before You Dig No Traffic Services Control No.
Show sketch of proposed work or furnish ':9 o be filled ������-� �o f South in {
two copies of separate drawing - s
Pavement Cut
Indicate North Prop. size of cut
No. cuts
3� Amt. of Deposit$ _ b f,
()Cash ( )Check#____ {
Cut size after Perm. batch
No. Cuts__ I
Final Billing t 4 +(
- Amt. Due Payee
Amt. Due Town $ i
Applicant is responsible for contacting by '
the Police Dept. and C.B.Y.D. 111 _date___
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND`3'0 REIMBURSE THE TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNEME.ON 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: Date:
Title:
PERM21T SHALL BE ` FPT ON JORST-rE AT ALL TTIME S
Standard Forms\Permits\Street Excavation Permit.doc