HomeMy WebLinkAboutDriveway Street Cut Permits 92 Nevers Ro n
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No
Location '-. ContXaC' 'or AIROTDI;
S. INC.
Type Work DRI hd'dres :
VEWAY P
b;O;UTH W'TNBbR CT;: 06074
Date Insp Needed
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44
Time Ins
p Needed
-------- Time 1419) ,
Inspected By — —
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Work in Progress e'
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Permit No. 4328 Town of South Windsor, CT
Date 11/01/2006 Street Excavation Permit
Expiration Date 11/01/2007
Descrip:
Applicant LgaCion
Name AIROLDI'S INC
flE3�3�' t�EVE3Za ROAb,
Addr. P O BOX 71
SOUTH WINDS OR CT '007§ pe Worj DRIV�$TAY
Phone (860)289-3876
Applicant agreed to. furx ssh the. Town;;off 56-dith Win dsd the atch nt of bond
required and to reimb'ti`rs t 'e own of catxth 7 n.clsor pr.:::any "expenses
incurred by the Towsi for maiFienne me 'rt +xbrk xicYryneGtikn with this
Fh
permit and that appi,ignt �s.; familiar with ancr33'1 ::abif `'kty the rules and
regulations for permZts as 'ouLlyd..:yy�" e ' izt,h'Windsor's Street
Cut Permit Manual
PER
MIT IT ;......
Issued by — ------
a
Date Completed _----------- .:.:;:, ��spe'C C e d By ��.
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm
Address of Firm
Phone No. 3�?
Location of proposed work
_Describe fully nature of permit requested_
Starting date \` o Approx. time for completion \\ ,
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or famish
two copies of separate drawing Indicate North0 This section to be filled out by
Town of South�Windsor
Pavement Cut
No.cuts
Est Size of Perm.Patch(s)
7�s
Est Pvt.Thickness in.
Est.Unit Price$
\ Amt.of Deposit$
Total Due$ by
( )Cash( )Check# .
Permanent Patch
No. Cuts
Size of Patch s
I
Final Billing
Amt Due Payee
w\� $
�— Amt.Due Town
By
Applicant is responsible for contacting ate
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 T�
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WO,
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATI'PERMIT UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: _
Date:_
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES