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HomeMy WebLinkAboutTelephone Street Cut Permits Pleasant Va REPORT INSPECTION REP . SOUTH WINDSOR ,GALE CONST CO TOWN OF Cont.: a"Ctor BIRO?<.L .:: ,.:::..:,. UE ;fs 7 3 S"Y;>. £� A�1FN. p 610 7 ��dres� HART��RD CT r 4144 FROM WEST 7,077 Permit NO py ASA vXLT-1X e No �$ }52.? TELEPHONE l U^ P1io?? Location Type Work fat Ts�s: 3 InsP Needed Date — --- _ Tatttie Izap Needed Time Insp --- ---'` _Inspected By _ ... Progress Work in —/� Town of South Windsor, CT • 4144 Street Excavation Permit Permit No. Date 02/14/2006 •„ ti Expira on Date 02/14/2007 HE r:.. AND-bIT Descrip: RELOCATE UNDERGROUTID CONDUIT�zNBT Locat3 d Applicant / pLL SANT VALT EY R AD FRCiM Name SIROIS & GALE CONST C4�' �� ', Addr. 73 SYLVAN AVENUe C�€ NbrELEPIDNE WEST HARTFORD CI 461(37. Phone (860)521-7077 Ab e >dm�unt of bond rees'.. to f�yru�s the nses Townf Stxutli Wlndar t Applicant ag ouh blxlxcsos fnr anY expe tibn with this te;ante or: repa ,r,wnrkxi! onC. required and to reitnbur�e t Tmw b tSe rules and the Town::: '`: .:. ::.. :..>. s•:::::..:_,::,...:>.:::<a:<:;::;g:.; i>..:;:`:.'.,>::.. bide; Y. incurred by axe w�l a permit and that applicant io tlinedpn of gquh �7a:nd5or's Street regulations for permits as Cut Permit Manual. * T.::k.:Tfi.+,..:. * * PERMIT TO �_ �— Inspected Pam`' -= ;;,--=�- - rr b I n s�:::.:>::>:.. Issued by _____-- ------ ------ By __ ---- Date Completedg �--�---- r APPLICATION FOR STREET EXCAVATION PERMIT ( 14- TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm e7i iL I's 464le'ec^N54 Co. C-LC. Address of Firm PO &-�4 C;S r /+,arLT Location of proposed work cAihF-k � v.�eti--i ale S' �cam {-i°G•i�.,S _Describe fully nature of permit requested 61"'4sx— `w � -�.. � Starting date v+s Call Before You Dig No. Approx. time for completion 3 /t r 0�. Traffic Services Control No. Show sketch of proposed work or furnish two copies of separate drawing Indicate North This section to be filled go_ut by Town of South Windsor Pavement Cut rw 4 4e4'e'A0 No.cuts __ Est.Size of Perm.Patch(s) V�1 Est. Pvt.Thickness in. 1 1i "4w 1 �' Est.Unit Price$ Z0 o b 616 o 2-121 Amt.of Deposit$ ( Total Due$ by 233 C& 0 Z 13-7 ( )Cash( )Check# ©b 0 zi 4�- Permanent Patch No. Cuts Size of Patch(s) Final Billing Amt.Due Payee Amt. Due Town By Applicant is responsible for contacting 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:_ �,��-�, �'�-� j Date:_- Title:__ t 'A i yj- 111 cm bl-k— Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES