HomeMy WebLinkAboutDriveway Street Cut Permits 232 Hilton D TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3859 / Contx,&Ctor QUALITY-PAVING CO.
Location 0232 HILTON DRIVE ' dge9:44*: ,"I ,MINA^`§T:REET
Type Work DRIVEWAYC :;06088
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Dat
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Work in Progress x
Permit No. 3859
� Town of South Windsor, CT
Date 09/28/2004
> Street Excavation Permit
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Expiration Date 09/28/2005 r`£
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Applicant
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Name QUALITY PAVING OM.
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Addr. 194 S. MAIN STR Et.. s 9 k;
EAST WINDSOR OP68088 If o'f t�o'rr T2
Phone (860)523-4182
Applicant agrees4to ur :i
3? 's k`t <Pc.'AMR., <<z t •.;,Wind q'ri`':C' ie°';tthiioLnt of bond
required d to reik bur : "~
q red an ita Se.,. o% Y ss:.::.•
>s ':'. :b,'�.*ary::e�'i�enses
incurred by the Towrf, €omfd3ece, Q.;.s>:2epa ; .,.wo with t
"ru .Ay.',3,.,.x::,.< a.:.., his
permit and that appl =.;caant i "farih:j..lfa ' ? € "<w"s. :;<::az :e by •ie rules and
regulations for permiC<s a,:'
,;:o Cl ne x a S'.;<.,of S;nuth•.4T3ria5or s Street
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Cut Permit Manual.
* * PERMIT TO Btu'?K P. .L,.LM>ES.
Issu ,��//�
ed by
Date Completed ---_---__—_-- Inspected By e� �fC
��t••-+ ivly ruK s I KLET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR `—
PUBLIC WORKS DEPARTMENT Permit No:
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm -
Address of Firm �, Phone No. ti5 07 y f
Location of proposed work
Describe ully nature of permit requested
Starting date �Lz.c t C1
Call Before You Dig o. Approx.time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out by
Town of South Windsor
Pavement Cut
c No.cuts
Est. of Perm.Patch(s)
Est.PvL Thickness in.
Est.Unit Price$
Amt.of Deposit$
1/
Total Due$ by
( )Cash( )Check#
Permanent Patch .
No. Cuts
Size of Patch(s)
------ -- - Final Billing .
Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contacting
the Police-Dept.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 OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: �� 0
Date:
Title:
Driver's License#: 6 3 L3/ 73 0,
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES