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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 3193 Contractor QUALITY PAVING CO.
Location FICA- k Address 90 STRONG ROAD
Type Work DRIVEWAY SOUTH WINDSOR CT 06074
�'hon No. (860)523-4182
Date Insp Needed Dctito- Insp. `f"Z Ze U�
Time Insp Needed Time Insp .,
Inspected. By
E :
Work in Progress
In°put Date
-Permit No, 3193 Town of South Windsor, CT
Date 08/30/2001 Street Excavation Permit
Expiration �,Date 08/30/2002
Descrip:
Applicant Location
Name QUALITY PAVING CO. 07,�9 GRIFFIN ROAD
Addr. 90 STRONG ROAD
SOUTH WINDSOR CT 06,074 : Type ,trf W C DRIVEWAY
Phone (860)523-4182
Applicant agrees to furnish -irh3 � r c € ap:uiv,�i Windsor the amount of bond
required and to reimbur' ae the "To
wn af, Soxti ` t 'nd�<ar for any expenses
incurred by the Town 'Far mat�nace spa i w� 'k.°.i 0 connection with this
permit and that appl icant J$s;�ami j ��r; w��� and, �v41`1° abide by the rules and
regulations for permi t5 $ 01 # , hP Tovvi�°.0 South Windsor 's Street
Cut Permit Manual , .
* * PERMIT TO BE.,, idFEPT ON .tJOb °fiTE `AT'. ALL TIMES.
Issued by
Date CompletedInspected ByL �-J
- APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR.-CT
FEE $25.00
Name of Firm ev1 Plane No, p� Y/00 2
Address of Firm C-1 OaZZ
Location of proposed work
Describe fully nature of permit req 4 W3
Starting date v Appm tine fir o 14
Call Before You Dig No. -- Traffic Services Control No.
Show sketch of proposed work or fumish To be filled out by Town of South Windsor
two copies of separate drawing
Payment
Indicate North Prop,size of at
No.aft
•AmL of Depose$ by
pCash()Check
Cut sae after Perm.Patch
No. Cuts
Final Billing$
Amt Due Payee$
Amt Due Town$
Applicant is responsible for contacting by date
the Police DepL 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
Signed: Z"'�ty� ' f Date:
Title: D.L.:
PERMIT SHALL BE KEPT ON]OBSrrE AT ALL TIMES
Standard Fornu\Permb\Sb vet Excavation Permitdoc