HomeMy WebLinkAboutDriveway Street Cut Permits 617 Pleasant TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4024 Con, aC`t'or'M&SPiNG AND SEALING, INC
Location O617 PLEASANT VALLEYS`3dre 43$ UC•KLANROAD
Type Work DRIVEWAY UTH"W>IDfi"S0.J2`'' .T 06074
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Permit No. 4024 Town of South Windsor, CT
Date 07/01/2005 Street Excavation Permit
Expiration Date 07/01/2006
Descrip:
Applicanto''
L c''ation
Name M&S PAVING AND SEAT I � TNT €f ; PIESANT �TALLX
Addr. 435 BUCKLAND ROAD �� <•..
SOUTH WINDSOR CT. 060 4• ::'""%':'s:. ";&::>: .f Wa,..j€:?.,..A, r ,TYR"SVEWAY
Pho
ne 860 64 -
Applicant agrees tp fuxsx sh the: io�tx rf auth W1ndear the r unt of bond
required and to roiMburlSE th"e 'Town of ScEt�tl z dsor''ffQx ,city expenses
incurred by the Town for mai.texia�a f� ai `i..Work n eonne tibn with this
permit and that applicant ' fam3 :� ,yrtka api wall aJ�iie by tie rules and
regulations for perm' °t zi "ycu >lned ;a:n:;:>ah�.::,o:t� .,..:�� -``"Sou``'h'i'r>a�ds'oi s Street
Cut Permit Manual ,.•
* * PERMIT: T� $E ART-`ON1$sEI TINES;;`"
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Issued by 0 h: title _
Date Completed
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APPLICATION FOR STREET EXCAVATION PERMIT Da
t TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm M 1� 5 Pao/\j6 D �sEA j4 AJ6a;f A t Phone No. aJ te g--/ I//.�
Address of Finn_ Ck1--0-VVb N bSOP, C71 6&67
Location of proposed
Describe fully nature of permit requested_i�6/►'I nu ,4 �E�L q E ! TII [7 'i►O�uJl4-`( /�iV
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Starting date 1 Approx.time for completion i
Call Before You Dig NL-N 7�2 0/S �Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be tied out by
Town of South Windsor
Pavement Cut
No.cuts
0 Est Size of Perm.Patctgs)
Est.Pvt.Thickness in.
Est.Unit Price$
Amt of Deposit$
Total Due$ by
( )Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
Finai BJThV
S
Amt Due Payee
Amt.Due Town
a
By
Applicant Is responsible for contacting Date
the Police Dept and C.B.Y.D.
1 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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE TOWN OF SOL WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: & - 3 D'
Driver's License#:
PERMIT SHALL RF KFPT nu_rngmn= Ar A.
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11"PAVING AND SEALING INC.
435 Buckland Road 6 5prino5ide Avenue
SEALINGMING AND South Windsor CT 00074 Danbury,GT 06810 Toll Free-1-600-466-5EAL
(060)648-1915 (203)790-9727 Email:5aleogrnooea►coat.com
Fax:(860)645-4602 Fax:(203)794-9172 www.m55ealcoat.com
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