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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 3 93 Contractor AIROLDI 'S INC.
Location 0 ^: Address 41 ZINFANDEL CIRCLE
Type Work DRIVEWAY TOLLAND CT 06084
'ham No. (860)896-0401
Date Insp Needed n e( ®-7—
Time Insp Needed 10 �M
Inspected By
Work in Progress
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Date
° 3393 Town of South Windsor, CT
Date 09/17/2002 Street' Excavation Permit
Expiration Date 09/17/2003
Descrip:
Applicant " Location
Name AIROLDI 'S INC. �A REET
Addr. 41 ZINFANDEL CIRC
TOLLAND CT 06084 DRIVEWAY
Phone (860)896-0401
Applicant agrees of kin sor the amount of bond
required and to rei T th oo or any expenses
incurred by the Tow t epa k n connection with this
permit and that appl ' bide by the rules and
regulations for perm lin c outh Windsor's Street
Cut_Permit, Manual . ,
w� it ti D
* * PERMIT T@ ALL TIMES.
Issued by F 1.1A e _ keys �JVG
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm YZ> Phone No.
Address of Firm 1P.0 boy `I k
Location of proposed work -It) Q0,Ac t �3,
Describe fully nature of permit requested=D q du+ o1c-�
Starting date_ -&-p4- q Approx.time for completion d2f '3 0 a 0_09-
Call Before You Dig No. -D-000 3 sr�).a j IR(P ._ Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North f e Prop. size of cut
No.cuts
1 > Amt.of Deposit$ by
()Cash O Check#
3a
Cut size after Perm. Patch
No. Cuts
13 7 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_ Date,
d
Title' D.L.#°
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permtts\Street Excavation Permit.doc