HomeMy WebLinkAboutDriveway Street Cut Permits 493 Griffin TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3999
Cow^facto; AIRQLb-"r:A.&; INC.
Location 0493 GRIFFIN ROAD r
Type Work DRIVEWAY Se `FIIN3S0'R `C:T 06074
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• Permit No. 3999 Town of South Windsor, CT
F Date 05/31/2005 Street Excavation Permit
Expiration Date 05/31/2006
Descrip: n
Applicant
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o:Pa::t ion
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Name AIROLDI'S INC. 0 �09 Gi2IFI R(7A1?
Addr.. P O BOX 71
SOUTH WINDSORT,: O.F F'; ;1 '
Q<5 ><<'`'' .C? Wc2JC D$Z. WAY
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Phone 86028 -
38
9
76
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Y $ S i
Applicant agrees.tQ uV} ssh>thenva ath Wia�d the •>&mount of bond
required and to Town (�f'S,�, th Windsorpr,'aYiy eigenses
incurred by the TdWn fbr niaa to x� x x a X?zork 3rr:: o2inection with this
permit and that appli< y 't:.,he rules and
regulations for perm is a's :is ib uth Willa or's Street
Cut Permit Manual.
� raj
* * PERMITaTO B KEPT ON, A :ALL TIDES.
Issued by �i Ti le
-------
Date Completed ""
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm
Address of Firm
Phone No. ?
Location of proposed work
Describe fully nature of permit requested _
Starting date T--�,CSI E7
c� Approx.time for completion_
Call Before You Dig N� Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
� � -' Pavement Cut
Indicate North 1 Prop. size of cut
No. cuts
Amt. of Deposit$ by
()Cash ()Check#
LIP Cut size after Perm. Patch
No. Cuts
Final Billing $
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting by - 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 PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
• 1
Signed: �� `L> Date:
Title: D.L.#:
PERMIT SHALL BE KEPT ON 308SITE AT ALL TIMES