HomeMy WebLinkAboutDriveway Street Cut Permits 5 Kent Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No, 3603
Location 0005 KENT LANE Cont,:rad't'or AIR6:LtDI-?S INC.
Address 41 2>INFANDEL;.;.CIRCLE
Type Work DRIVEWAY
IO.LLAND C 060& '1
Phone fTo ,.f6x,0).896 F}4,01
Date Insp Needed �
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Time Insp Needed
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Inspected By
Work in Progress
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Input —/
__` Date
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Permit No. 3603 Town of South Windsor, CT
Date 10/06/2003 Street Excavation Permit
Expiration Date 10/05/2004
Descrip:
Applicant Location
Name AIROLDI'S INC. bD4 ,' KENT 11NE"a
Addr. 41 ZINFANDEL CIRCLE '
TOLLAND CT 06084 Type;a€ Work DiTVEWAY
Phone (860)896-0401
Applicant agree8 to furin sh the TG n t rauth Winz3sgs Che =amount of bond
required and to re#mburse'ahe Town of::Sauth;.WXndsor fQr" any :"expenses
incurred by the Town ftdr ttta2nCen� ce ar rep a,r Wo:rk axi . onnG 'titan with this
permit and that app ica:.Ati fa„mi l�zr:wi .h.':anti ws'11 abX by the rules and
regulations for permatS. as o�it7, rtec the T w�.o;f Soutj Wjri'':S(s is Street
Cut Permit Manual.
* * PERMIT FO"B$, KB'PTI.J. N $ ? AI."ALL TIMhS .
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Issued by — —__ Title
Date Completed "'"' <».>;:::..._
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
l� FEE $25.00
Name of Firm e ��s :1Loc- . Phone No. z
Address of Firm P 0 ibc:�, `711 Sov-Vr\
Location of proposed work t K e.%�-
Describe fully nature of permit requested l -.rne e
Starting date io 3 Approx.time for completion %u- 3 -i 5
Call Before You Dig No. Z006 •`100 340 J Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
4 i et No. cuts
Amt. of Deposit$ by
j O Cash O Check#
v
Cut size after Perm. Patch
? No. Cuts
waL�
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 FURI`lISH 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:_4az A-4 C Date: id
Title:_ 4 1� z D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc