HomeMy WebLinkAboutStorm Street Cut Permits 65 Oak Street TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 3642 Contractor BUL LUCK.,;;COMPANY, INC.
Location 0065 OAK STREET Address CLIFFORD BULLOCK
Type Work STORM 123 MT"DDL:E RD
LLINOTON CT 0602.:9
ghOTye. No ��6Op;870 Z4;g4
Date Insp Needed Datt : Ia �"
Time Insp Needed
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Inspected By
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Work in Progress C't��r
Input" Date— -6 V
Permit No. 3642 Town of South Windsor, CT
Date 12/11/2003 Street Excavation Permit
Expiration Date 12/10/2004
Descrip:
Applicant L4cat i'qn
Name BULLOCK COMPANY, INC p66S .QAK STET
Addr. CLIFFORD BULLOCK;
ELLINGTON CT 060125 � ? e af WoC STO; M
Phone (860)870-7444
Applicant agrees, to fuknaslti the .,TQty ey ,South Windsor >he;atn6unt of bond
required and to reimFiurs ,the Torn of 541kth",WdsQ:r fcasiy ''�xpenses
incurred by the Town for pttntenance o repair wor;:) zeon ti :q.ton with this
permit and that applicant is. 'fami5 is ?a3 d waT;7 abi'ae by the rules and
regulations for per a;s. out'lined.i�athe g P oxTn of S.ut11 W.Zndsor s Street
Cut Permit Manual.
* * PERMIT TO`"$E. JiP;T ON 'OB S3TE AT ALL, T61;42S.
v
Issued by
Date Completed _—__ Inspected By KIT,-----
'` APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm 77.e 130 -LoCk- Cry Z-,c Phone No. �?60--F7y-7 `i 4y
Address of Firm_ )'2-3 Vti, , '? ') 20/1-,7 <LL c 6 oZ.j
Location of proposed work 6s- 6 4k ; Sc�I ;�, ,,�� �� _ �_ < 0-77
Describe fully nature of permit requested L -F JI-11;1i
Starting date 1 Z-S,v,3 Approx. time for completion
Call Before You Dig No. L-:-,j n')c, E1` > Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts Y 14
Est.Size of Perm. Patch(s)
c7✓1'l� S;9-E�-
C ^) A ) Est. Pvt.Thickness in.
Est. Unit Price$
f Amt.of Deposit$
Total Due$ by
w 1 ( )Cash( )Check#
q Permanent Patch
No. Cuts
Size of Patch(s)
n_ vRk. S i
Final Billing
$
Amt. Due Payee
D Amt. Due Town
$
BY
Applicant is responsible for contacting 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 TOWPt OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: L-3 --U 3
t-- f 'V 4��Title: r-e') , o,=:V; Driver's License#: O i 3.5 �b L 32
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES