Loading...
HomeMy WebLinkAboutDriveway Street Cut Permits 204 Newberry TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3678 Cont.x'aa or A:" °"S''s<>:<.CONSTRUCTION, INC. Location 0204 NEWBERRY ROAD Addre P C ::DRA$TER`^ ;. Type Work DRIVEWAY EAST GRAN] Y CT" 06026 :Phone No ( ) Date Insp Needed at ��as ------------ p ff Time Insp Needed -----_—_A—' Time T' Inspected By Work in Progress �'w -------------------------------- - - i Input Date -- -1� y Permit No. 3678 Town of South Windsor, CT Date 04/19/2004 """ Street Excavation Permit Expiration Date 04/19/2005 Descrip: Applicant Locaten Name A.F.S. CONSTRUCT"ION INC 0204 NEWBERI .ROAR Addr. P O DRAWER S EAST GRANBY CT 0�,026 Worl. �RIUEWA' Phone jj Applicant agrees 't�s fuxrf°iski+' the Towft cif South Winds.c.r.the amdunt of bond required and to reimburse the TdWt o :Soutki W3d�dspr, for 'anyCpenses incurred by the Towh for a% . t narYce 'or' repair'W'Ork 1A onq. ct 'on with this permit and that appl;iQant 1*S f m�<liak h a'hd cvi1; . h2 e by the rules and regulations for permits as '©ut'�iried zi.the Town of Sout'h 'k nd:sor's Street Cut Permit Manual. * * PERMIT TO'BE FEPT ON �7CQ,$ ...S ;TEi ALL: TIMES. Issued b -�1 tle: y ------ �i — ------ — Date Completed _ Inspected B '4 -") 5 APPLICATION FOR STREET EXCAVATION PERMIT _ TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT - TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm Phone No. Address of Firm Location of proposed work Describe fully nature of permit requested Starting date 14— Approx. time for completion__ Call Before You Dig No. Traffic Services Control No. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor Pavement Cut No. cuts Est.Size of Perm. Patch(s) ! Est. Pvt.Thickness in. i Est. Unit Price$ GCG Amt.of Deposit$ Total Due$ by �2 ( )Cash( )Check# Permanent Patch No. Cuts Size of Patch(s) Final Billing Amt.Due Payee Amt. Due Town By Applicant is responsible for contacting Date the Police Dept.and C.S.Y.D. 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 TO OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: ! Date: Title:_ Driver's License#: (sy�l2 PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES