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HomeMy WebLinkAboutDriveway Street Cut Permits 137 Orchard TOWN OF SOUTH WINDSOR INSPECTION REPORT Perh4it No. 3869 L / Cont,�a4ctbl`` 'fkb'tDl,k, INC. Location 0137 ORCHARD HILL DRI Z d res _, P p Type Work DRIVEWAY gOUTH *TNYOR CT 06074 Phony 34.76 Date Insp Needed Time Insp Needed +$iE .... f:3.:. ... :: In spected P ec to d B Y E Y. Work in Pr ogress � J '■+� f _- Permit No. 3869 Town of South Windsor, CT Date 10/08/2004 "..•. Street Excavation Permit e Expiration Date 10/08/2005 Descrip: F'. Applicant li can s o c. ':L ��1i o u:F:z v Name AIROLDI'S INC. Oi ORCHARD`: ;Z.FL"<;;DR'T' Addr. P O BOX 7 1 SOU TH WI ND SO R C T 0 7''v. Phone (860)289-3876 ;:::u;;•.:. :ry Applicant agreed. t"o"""`.f' 4 Lxril ?the .a=iz.:. ., Lh WincZ"'© .; ,r :!:!:.'r:'<>;::.. S.x:<tie'...ari�ount of bond required and to re #nbrs"'. a' >'"�..;:.:.,�:� ��['ore&':`.::> �a'��u�h!:.>�4�"!'::s'. r .�;. .;o f:'�Sr':r:a` nses incurred b ". Y the Tow xt fn kenance ox° e{S it *n+c3 7� X.0-1 c—n with this permit and that appl'IcA t Vb 41g, Iiw �Ysa i ,*** . ]jy"`tie rules and a c:e regulations for permits as., a:t4.isiec theq of" Ssut3 31. T�amdor's Street Cut Permit Manual. lyf r * * PERMIT TO`::BE P AOT:.> Q$, ::... 4 <:::: +`<•AaL .yT' M :S Issued by V Date Completed Inspected By .-VA ,._ APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSORf CT FEE $25.00 Name of Fir►nlr� Phone No. `y ;� Address of Firm- Location `T _ . j of proposed work Describe fully nature of permit requested Starting date o Approx.time for completion Call Before You Dig No�_��s:. \c�� - Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate drawing Pavement Cut Indicate North Prop.size of cut No.cuts Amt.of Deposit$ by ()Cash()Check# Cut size after Perm. Patch No. Cuts Final Billing$ Amt. Due Payee$ ��\ a Amt. Due Town$ Applicant' �esmnsible or coni acting_ by date the Police De and C.B. 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 JOB- SITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc