HomeMy WebLinkAboutDriveway Street Cut Permits 223 Norton L TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3 B;
Contractor AIROrbl:,:F„S INC.
Location
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Type Work DRIVEWAY "+_
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Permit No. 3685 Town of South Windsor, CT
Date 04/26/2004 Street Excavation Permit
Expiration Date 04/26/2005
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Name AIROLDI'S INC. T
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SOUTH WINDSOR
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Phone (860) 896-0401 `'
Applicant agrees to:: f-U-i&i0. the IF` '.r;>ci' .::raw`- ":•h Win '`'
as xzy:;
ditC d d:%—he...,,am unt of bond
required
uired and to re; u s'
q x ,t:l: iTc `rt •': ..:: 'c�* tf :f '<sila.ar .: or:<asinses
incurred by the Tov1#1 >.:€.5'r':; a, rt: n a n c e oY repair W.t.5r z<c6n ct on with this
permit and that appl;i` "ant s? ;iri ` : a :?. .::..:';d .:::Vi* <: b'i' e:,`b h wr» 1,,., $ y`C e rules and
regulations for permits as `'pctliried: '.,the',£. a" ofKS'i,th'W.yrndsor's Street
Cut Permit Manual e..
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* * PERMIT TO aBE' ':E
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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 $25.00
Name of
Phone No. �
Address of Firm `� u
Location of proposed worker o
Describe fully nature of permit requested
Staiuiiy ud%e Approx.time for completion --\"�
Call Before You Dig No: Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
No.cuts
�. Amt. of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing $
/ l 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: Date:
Title: D.L.#:
PERMIT SHALL BE KEPT ON 7OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc