HomeMy WebLinkAboutDriveway Street Cut Permits 701 Graham R TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4057 Cont„ .ae (3r M&S�" VJNG AND SEALING, INC
Location 0701 GRAHAM ROAD A$drez 435 QUC AND:,�R0AD
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Type Work DRIVEWAY . '
YP s +' SOUTH Wl-NOR kt-T. 06074
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Date Insp Needed Da . `f€
Time Insp Needed
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Permit No. 4057 Town of South Windsor, CT
Date 08/04/2005 Street Excavation Permit
Expiration Date 08/04/2006
Descrip: 44. „ ;.
Applicant s' o d 4 `a 4oc Lion
Name M&S PAVING AND S�M: I T TNC '��� RAI A44 Rp sD
Addr.. 435 BUCKLAND ROP
SOUTH WINDSOR QT 0607 r fl Work DFrfiU WAY
Phone (860) 648-1915 °yry
Applicant agreed to �il Jim.� her�`'� ���'��h Wir�r1 �thejtipunt of bond
required and to re,&"u se tla� down of Eovxtk� �sdsor Tir aiiy expenses
incurred by 'the Town f r f x ssa r ' w k
r e f xt T � or bnneetion with this
permit and that apXalic$nt x ram � �+ yxi �xik�d by` flee rules and
regulations for permit a ztz�edt AIR
t epabth"Wrrds'r's Street
Cut Permit Manual.
* * PERMIT'TOY SE &PT- ' � „$fL TsIMEt3 *``
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Issued by .IT(`/
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Date Completed _—__----__— "Tiispe,ctaEY�Byl—V~9r
APPLICATION FOR STREET EXCAVATION PERMIT 051
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm_j�4� S \(i N(ni 3 b S�LI IJ(R , J N Phone No. (g k6) b q S--1 q S�
Address of Firm )Z 35`
Location of proposed work
Describe fully stature of permit requested
Starting date_ g a •O S Approx.time for completion 7 o O S
Call Before You Dig No,a70 09-31 O.Q$S3 Traffic Services Control No.
tw0
00c sketch of or furnish
y toClicate North This section o be f
` - - Town of SmM windsor
Pavement Cut
No.cuts
0 Est°Size of Penn.Patch(s)
EsL Pvt.Thickness in.
EsL Unit Price$
Amt.of Deposit$
Total Due$ by
Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
FIrW Billing
$
AmL[hie Payee
$
Amt.Due Town
$
By
Applicant is responsible for contaeft Date
the Poke 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
PERMIT OUTL:a�:=
R`S STREET CUT PERMIT MANUAL.
S° ned:
� Date: 7'
Tine: -/ACA 7— Driver's License#:
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