HomeMy WebLinkAboutSidewalk repair Street Cut Permits 790 G 700116 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/30/07
GIS ID: 37500790 FEE:
25.00
MUNIS APPLICATION# 200701182 - ` IRATION D
`< ATE: 07/29/08
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CAT I ON
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NAME: COSTA&SON,LLC "`'.,
ADDRESS: P O
BOX 658AD
AM ROAD
PH P&LINDA M
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SOUTH WINDSOR,CT Jf074
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CT 0 6074
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SCRIPTION:
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APPLICANT AGREES TO FURNISH THE tO WN.01r: U`I FI:' F.'.:.�
.. tMO :N3 `REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR Al°V E, , I L IN+ f IY F-'O N,'PC IyTA NTENANCE OR REPAIR WORK IN
�.v
CONNECTION WITH THIS PERMIT AND THV A''PIj.dA-' StF fD:t�VIT'I BIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF>S i3 T?VIN- S`R,'S; IT-R- 3 @I7T P.ERIyITT 1VIANUAL.
ISSUED BY D`' E<; 5'.ECE7 INSPECTED BY
7/30/2007 10:45 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l7 ao II & CONTRACTOR: C0,51,A'
LOCATION: �� 9 O ka b ►vim V-0 .
TYPE OF WORK: S 1 C
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: �ra
HeavPC Le
AS-BUILT:
J1�f S`Z
INPUT: DATE: �
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
1 FEE $25.00
Name of Firm �o t—� So
1— e- Phone No. 262
Address of Firm"O.
Location of proposed work A n
.Describe fully nature of permit requested_��,�
S � wc�l /C
Starting date �igg
3 0 0
Approx. time for completion
Call Before You
No. Traffic Services Control No.
Show sketch of proposed work or fumish
two copies of separate drawing Indicate North This section to be filled out by
Town of South'Windsor
Pavement Cut
No.cuts
Est.Size of Penn.Patch(s)
c� -7 Est.Pvt.Thickness in.
-` / qe Est.Unit Price
Amt.of Deposit$
Total Due$ by
( )Cash( )Check# .
Permanent Patch
Cot- L�r� No. Cuts
Cr"Y Size of Patch(s)
v " Final Billing
Amt.Due Payee
Amt. Due Town
TLAI �� $
By
Applicant is r spqnsible for contacting
the Police De t.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 F ILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE T N OF UTH W SOR'S STREET CUT PERMIT MANUAL.
Signed: �-�- �- Date: 7 �J v Off'
Title: e�
Drivers License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES