HomeMy WebLinkAboutStorm Street Cut Permits 200 Northview D TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit'No. Contractor PAGANI CONSTRUCTION
Location Address 15 KING STREET
Type Work STORM ROCKVILLE CT 06066
"Phon.e No. ( 860 )872-7757
Date Insp Needed wilt CA DAt:6 , Insp .
Time Insp Needed Tirne� in p ,
Inspected By
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Permit,, No. �i 3256 Town of South Windsor, CT
Date _ o * 03/20/2002 Street Excavation Permit
Expiration Date 03/20/2003
Descrip: CONNECT FDN. DRAIN TO CB IN ROAD
Applicant Location
Name PAGANI CONSTRUCTION _�d ;bC ..,NORTH'V,IEW DRIVE
Addr , 15 KING STREET
ROCKVILLE CT 06066 �:Ty;peofWor�t STORM
Phone (860)872-7757
Applicant agrees to -�f:ur�nTsh" the Town of South Windsor the amount of bond
required and to reimbui^s'e tha T'own o,f:° South Windsor-for any expenses
incurred by the Town for: ma . tena�nce '�or:: repai r wor in connection with this
permit and that app l i a t 'i-s,� farm.l.�� with, and"w l l, .ak i de by the rules and
regulations for permit>s ,as`'outlined in the ,ToWn of South Windsor's Street
Cut Permit Manual .
* * PERMIT TO BE, KEPT ON J08. `SITE Al- ALL TIMES .
Issued by T i t l e (rt,�. �uG-
Date Completed Inspected By _
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm tj Phone No. G � ,
Address of Firm I " r-J O �;
Location of proposed work V' emvv 3-Z-0-711 Z
Describe fulyr nature of permit requested 1 ,
Starting date q � • . ' � - � �5 i
Approx.time for completion 3 A
Call Before You Dig No O 00 ' 1 k Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
F�- , ��N��vfS � Pavement Cut
Indicate North Prop. size of cut
2-ao
i No. cuts
t
Amt. of Deposit$ by
iLiL
i ()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
TOWN0 CUT PERMIT MANUAL.
Signed: - �''�� Date: 0�
Title: t N D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc