HomeMy WebLinkAboutDriveway Street Cut Permits 15 Judy Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT I
Permit No. 4116 Contxattor AIROLTSY+S„ INC
.
Location 60It
E Addres•s; P 0 BOX,•7
Type Work DRIVEWAY St��TTH WTND$OR CT; 06074
Phone Np': (8G3).289 76 :.
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Date Insp Needed
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Time
Insp Needed
it
Inspected By ; �
Work in Progress
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Permit No. 4116 Town of South Windsor, CT
Date 10/31/2005 Street Excavation Permit
Expiration Date 10/31/2006
Descrip:
Applicant Lo-a.t'ion
Name AIROLDI'S INC. (�0T 5 :7LxAX.LANE
Addr. P O BOX 71
SOUTH WINDSOR CI .06fl7A;' pe Cx ,';Work DRIkTEVAY,
Phone (860)289-3876 s
Applicant agrees; to furrsh the "Ersw.r� cry611 -ki Windsor; thetnount of bond
required and to reLMburse''ti'kiq `,#'own af, $atz h �r7 x1f sor f any expenses
incurred by the Town es m ;lhC n ea 5 r p r Rzprk i c'orxhe ,icsn with this
permit and that app]icant zs fuil 'ar`"wYth and w3'11bz�€ b the rules and
regulations for permit as ;outl f2 d 1 Y j Ca #Y fi `,5€?u... Windsor's Street
Cut Permit Manual.
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* * PERMIT ' Q BE'KE PIP, ON„J #T°i AT ALL Sk�E5..
�aIssued by m Tit1,e
Date Completed _ "'""" >InspC'ted By
APPLICATION FOR STREET EXCAVATION PERMIT A TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm ,"m\. S �" ,
Phone No.
Address of Firm_ S
Location of proposed work \S
Describe fully nature of permit requested
41—
Starting date
Approx. time for completion--\ Z'-\ e;
Call Before You Dig No.
Traffic Services Control No.
I Show sketch of proposed work&rfamish
two copies offseparate drawing Indicate North This section to be filled out by
Town of South Windsor
Pavement Cut
No.cuts
�J4'-t 0 Est.Size of Perm. Patch(s)
Est. Pvt.Thickness
in.
Est. Unit Price$
C( Amt. of Deposit
Total Due$L-,by
( )Cash Check#
Permanent Patch
I No. Cuts
Size of Patch(s)
Final Billing
$-----------
Amt. Due Paye'e
Amt. Due Town
Applicant is responsible for contacting By ......
ppl t
Pol
ice
r)
the Police ept.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
PERMIT OK�INED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:
Date: C3 S
Title:—.
Drivers License#:
Or-Dhfil-r QUA) 1 no