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HomeMy WebLinkAboutDriveway Street Cut Permits 191 Hillside TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3853 Con,t:ra` ' or AIROLD "'`5:::::INC. Location 0191 HILLSIDE DRIVE AcTdress >:p O QX. 71 Type Work DRIVEWAY Sb-uTH WT'NFT �R C06074 Ptsone 7vv Es }°289' �e6 Date Insp Needed ------------ --- Date I .s �/ 34 Time Insp Needed r Inspected By !� Work in Progress — — — --- - Input -- ' :Bte Permit No. 3853 Town of South Windsor, CT + Date 09/16/2004 Street Excavation Permit Expiration Date 09/16/2005 Descrip: Applicant liveata on Name AIROLDI'S INC. GT1 HI$,Is$I;E7E DRIVE Addr. P O BOX 71 SOUTH WINDSOR C' ;O6:QA:' ty re y „Work Dk--- E'S9AY Phone (860)289-3876 Applicant agrees to fursaish Ehe TO-w the amount of bond required and to reimburset of . 'own of. . rauth 6 i clsor fob ,and .ex�e;:nses incurred by the Town`.:fir rtlyt2�tenXxe ,� rpr ivtirk iai corzncti©n with this permit and that app'li-Q.o t f milia'r with nH ttaiT'1 ahx;ce by the rules and regulations for perm: .5 as,, outlsnet ii: 5 pWs� a $Dort; Windsor's Street Cut Permit Manual. PERM IT 'T.O>:>•B R;, E.p'>::: ,``:? '>.. I':»» `r..•...... Issued by _ ° : y� Title Date Completed ---------------✓ nsfreeted By _?, APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm Phone No. J7 Address of Firm Location of proposed work�. Describe fully nature of permit requested`', Starting date Approx.time for completion Call Before You Dig No, Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate drawing Pavement Cut Indicate North Prop. size of cut No. cuts Amt.of Deposit$ by ------- Cash O Check# it 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. SigneN�\',"' Date: Title: D.L.#: PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES Standard Forrns\Permits\Street Excavabon Permit.doc