HomeMy WebLinkAboutDriveway Street Cut Permits 529 Graham R w i
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permitxx
No
Location Contractor ,AIRpz,DT=S..INC.
Type Work DRIVEWAY Addtess ,P C' RGY 1
:4II:T .. IALI3S.E.R;.,' 06074
Poe Na ;($ fl� B9 38.:76
r
Date Insp Needed
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Time Ins Needed
d
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Inspected By
Work in Progress fpC.r
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—_:�,� Date
Permit No. 4163 Town of South Windsor, CT
Date 03/27/2006 Street Excavation Permit
Expiration Date 03/27/2007
Descrip:
Applicant:;' Lbcatfon
Name AIROLDI'S INC 0529 URAH.-A
Addr. P 0 BOX 71
SOUTH WINDSOR 6074:: "Pay .A7OYk pKVW1IY
Phone (860)289-3876..<
Applicant agrees to furnir. the T wri f South —W. d'§or. the �rtount of bond
required and to reimb'`urse t'ii Toni n tf',S�ukxIid�'ctir for and expenses
incurred by the Town for mainCeriance r� Ypa3Y wort in c:bnnection with this
permit and that applicant s .ta:mabide.'by .:the rules and
regulations for permx;ts as `our- ined ziz,' qwn ,of'"South: Wi ndsor's Street
Cut Permit Manual.
* * PERMIT TO"'^a$E >KER:: ..pNTE}B>'i2I"rr:<.AI
Issued by --- :
Date Completed ............. Inspected By
_ APPLICATION FOR STREET EXCAVATION PERMIT J 1 (e3
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT'
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm �
Phone No.
Address ofFirm,� .(z� _ ® `1\ ja���. ati .� Q— O
Location of proposed work Sa`ao1
Describe fully nature of permit requested av� 4,_
Starting date
Approx.time for completion ±{-
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or famish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
Est.Size of Perm.Patch(s)
^flit A Z1�
Est.Pvt.Thickness in.
Est.Unit Price$
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
PERM LINED IN THE TOWN OF SOUTH WINDSOWS STREET CUT PERMIT MANUAL.
Signed: Date: �`�\�
Title: e����\ �Qa��o.�•r Drivers License#:
DCOAAIT QUA1 1 RC 1lCOT n111 V10QMC AT Al i TIMCQ