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HomeMy WebLinkAboutReplace sidewalk slabs Street Cut Permit w TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3695 Contrac,tox-:Q08-s£:A.:,;;�; SON, LLC Location 0030 HERMAN WAY Ad Tess P.O.,:>HOX Type Work MISCELLAN 3� SUUTYi'W.11ID. R`:..:va 2 06074 (!Gn I���S IAC3L ✓IC I.WAG)C. SL�';CSS hone i1�a:<''�<$ 1:'64 499 Date Insp Needed x ----------------- Ddte Time Insp Needed 4 Inspected By -------- t:. yx'4 - -. Wo rk in Progress ess 40 :... L Plarmit No. 3695 Town of South Windsor, CT Date 05/04/2004 Street Excavation Permit Expiration Date 05/04/2005 " ? Descrip: REPLACE SIDEWALK SL1� S,; c3 `. APP 1i ant I. c y..N G ice'. c...: Name COSTA & SON LLC Addr. P.O. BOX 658 : : v SOUTH WIN DSO R '£ Q 7.4 LAid:::;:> Phone (860)644-2499 Ap plicant cant a r eesv `f a Y^ri"� 9 �. own''�'o `>�a'f3;�;:� WindS ' e �amo'n- l t of bond required and to reitnburSe''ti' ° ow is,or fete;"ati° e ''eases ? P incurred by the Town fot man .gnaY2i k z % 6onnect- with this permit and that appll�d:AV h and.xw ,1:.:>-a'1�. ' e: b;`':>.•t'h rules an regulations for permitS as " ud'i; ::;.': ra o ;.,,::;Sot.: k:>'Wrindsc is Street Cut Permit Manual. * * PERMIT Tb:::,.B'F KSPT'"0:N.`'=.St -::,AT'.:;.A L: TT'NFES. " Issued d b /✓ 't. Date Completed ca Inspected»,:.F:<. _—__ _ e By _-�. APPLtCAT10N FOR STREETXCAVATIDN PERM-IT 365. TOWNOF SOUTH WINDSOR" Permit No, , PUBLIC WQRKS DEPARTMENT TOWN HALL 1540`SULOYAN AVENUE SOUTH WINDSOR,'CT 06074 / FEE $25.00 Npmay of Firm _s.TA' S_ S o' .� ,. L U Phone No.Address of Firm. / O• (3. L P F tign of ro ose d wor N. r p, r� k 3�: © (� 7 DesGnf�e fully natiure of permit requested r.. a< < s • . �� : s utafttng detef S s' 01% Approxs time for com let'on - Oall Before y'0 U Dig No. , - Traff services:Control No: r ShovK sketch of piQlSosed work or nish " two copiee'of.seperate dravtrirt t r Indic ate North This seet,oil tb fill out b '1'ownof Sotif Windsor Pavemd tt 4' " k No.cu#s=- Est Size Of Penn Patch(s) Est PVt'rrThjqkrjess in:, St-Unit Price$ Amt.of Deposit$ , Total-Due$ by Cash t Pe"Ono" Patch Size ofl�atch(s) FinaTBilling Payee Amt Due Town Applicant.is responsible foC.Con#apting" the Police De t and I AGREE THE TOW WO TO FUttNISH TO N QF SOUTH WIND50R THE AMOUNT OF BOND:`REQUIREp AND TO REIMBURSE THE TbiNN O SOUTH WINDSQR FO.R ANY EXPEiUSE6 INCURRED BY.THE TOWN FOR MAIL TENANC-E 'OR REPAIR WORK IN AQONNIrTiON 1NITH THIS PERMIT AND THAT I AAA FAMIL"-"IAR WITH AND WILL ABIDE BYTHE RULES AND REGULATIONS FOR PERMITS.AS OUTLINED IN THE TOWN OF SOUTH ININDSOR,S STREET GUT PERMIT MANUAL Signed '� Date: it1e:_ Driver's License#: f- PERMIT SHALL'BE KEPT ON JOBSITE AT ALL TIMES