HomeMy WebLinkAboutDriveway Street Cut Permits 45 Horizon C TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3974
Location 0045 HORIZON CIRCLE Cont ""' �} W ,,s INC.
Type Work DRIVEWAY
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,P* IOUTH Gi< NE3OR }`e: 06074
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Time Insp Needed
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Work in Progress
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Permit No. 3974 Town of South Windsor, CT
Date 05/13/2005 Street Excavation Permit
Expiration Date 05/13/2006 {N
Descrip:
Applicant A
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Name AIROLDI'S INC. $pIpITtCIRC7E4
Addr.. P r3 ?;,. >.xfav
O BOX 71 .. ... ::..,�'..:;�
SOUTH WINDSOR CFP<»-0 0 T)!``:::;.:`... :u,• CY✓v 4° :'£'l, Wo .
Ss ?�y &7y7EWAY
Phone (860)289-3876 : u
Applicant agreed yipursh theW �vtth WidS�� t � Fmpunt of bond
required and to re mbu se ttxe3Pown of Eq t ,�adsor I any expenses
incurred by the To&ln r�r`' m i e ' ?ork n doxinecEi n with this
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permit and that app�q. is&�A` . ;amr w1l. I, tk3e rules and
regulations for er
P iiY'da i s Street
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Cut Permit Manual. ` yF `
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* * PERMIT TO B APT
Issued by --- —�L�/� � N Title ' c
Date Completed d B
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of 1 Phone No
Address of Fi
Location of propos worker
Describe fully nature of permit requested - "
Starting date` l S Apprax.time for compietian I _
Call:Before You Dig Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No. cuts
Amt.of Deposit$ by
()Cash()Check#
Cut size after Perm. Patch
.�.
No. Cuts
} Final Billing $
Amt. Due Payee$
\ C Amt. Due Town $
Applicant is responsi �f-brco acti4i by date
the Police De t.and C.B.YD.
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 WINDSdRs STREET CUT PERMIT MANUAL.
Signed: \\ Date: �� \
Title: D.L.#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard FormsWermits\Street ExcavaEion-Permit.doc