HomeMy WebLinkAboutMiscellaneous Street Cut Permits 15 Gran f
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Plirmit No. 3882
Contrdt'6Y Location 0015 GRANDVIEW TERRAC "I< CFIA�YS[�z BUILDERS LLC
Type Work MISCELLANkeres ,„ 75 H1;CKNUI�1 LVD
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Time Insp Needed
Inspected By
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Permit No. 3882 Town of South Windsor, CT
Date 11/05/2004 Y! Street Excavation Permit
Expiration Date 11/05/2005
Descrip: EXC. AND INSTALL BpX' E R`"SxpE A ,r"`'*`<:•<:`.,
� >
Applicant
3'
Name K
:
OCHANSKI BUILDE9S L'2C'::'r:•i.....:..,s'
GRANDVI'rx>r...DVI'
- FI 'FE�RAe''
Addr. 75 HOCKANUM BLVIT "`
,} L
VERNON CT 060 66 x
Phone 86
0)559-5140 Ap
plicant
scant a ree
g u:rn! 'sh'„`the`T, wn`.;:.:.:
c} u Windo tY#e artoL�nt of bond
required and to reiinbs e the qd4+m g3u h S SS$bQr frx arty expexises
incurred by the f To rs: p„„ ; Yua: tnari :.:tyf: pai'sex:::'ya "k:::> Tstiyttinecti n with this
permit and that appl'j.c: t
a7idytre rules and
regulations for ermi`
P ts as. c ti3.ZWinclsbr's Street
Cut Permit Manual.
* * PERMIT TO"'>:.B .XtPT (ON..'J:.B%
T.'_:AV ALL!':.'DIMES`..
Issued b
Date Completed _-------- Inspected By
rvK.51 WET EXCAVATION'PERM`IT `
TOWN OF SOUTH WINDSOR --
PUBLIC WORKS DEPARTMENT Permit No
TOWN HALL �4 386L
r 1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm . ,�o� �/�,Nf �!� /3 1�,�5
Address of Firm U Phone No,_SGDD
Location of proposed work
N
Describe fuly nature f permit requested
o r c.✓ S S io
Starting date
Call Before You Dig No. D 3 Approx.time for completion D
Traffic Services Control No.
Show sketch of proposed w rk or mish
two copies of separate dravy ng Indicate North This section to be filled out by
Town of South Windsor
Pavement Cut
No..cuts
Est.Size of Perm.Patch(s)
L___j v J S ;ve 4((CS
Est.Pvt.Thickness in.
Est:Unit Price$
De-OA14? 2 e lAmt.of Deposit Total Due$ by
Cash( )Check#
f� Permanent Patch
No. Cuts
a
Size of Patch(s)
fora G.or 3
----- -- _ _ - $Final Billing .
Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contacting
the Police De t.and C.B.Y.D. Date
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 OU IN THE.TO p W DSOR'S STREET CUT PERMIT MANUAL.
Signed: D
Date:
Title:
Driver's License
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES