HomeMy WebLinkAboutDriveway Street Cut Permits 196 Newberry TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3-�73 Contractor EASTERN WATERPROOFING
Location 01, *EMWRRY �RbAD Address P.O. BOX 504
Type Work DRIVEWAY SOUTH WINDSOR CT 06074
ne No. (860)875-6646
Date Insp Needed
4 I
Time Insp Needed
Inspected By
Work in Progress 1
a
SOR.
C Date ��/
r, No. 3373 Town of South Windsor, CTY
De 08/19/2002
Street Excavation Permit
Expiration Date 08/19/2003
Descrip:
Applicant ► Location
Name EASTERN WATERPROOF
ERRY ROAD
Addr. P.O. BOX 504
SOUTH WINDSOR CT k DRIVEWAY
Phone (860)875-6646
Applicant agr 00i dsor the amount of bond
required and to re out r for any expenses
incurred by the To n e rep r in connection with this
permit and that ap 1 i h TAY abide by the rules and
regulations for per u South Windsor's Street
Cut Permit Manual . t
* * PERMIT ALL TIMES.
Issued by ......�� S COle r �•
Date Completed Inspected By
ti
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Iry v':1rc, Phone No.
� s cD6y G
Address of Firm L- MA%v�-I U
Location of proposed work 1
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig N o I Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No. cuts
Amt. of Deposit$ by
()Cash( )Check#
Cut size after Perm. Patch
No. Cuts
Final Billing $
_ - --- -------- ----- --- -- Amt. Due Payee$
_ _.�................................ Amt. Due Town $
Applicant is responsible for contacting by,date
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 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: �&- �J L
Date:_.
Title:Pnl � D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc