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HomeMy WebLinkAboutMiscellaneous Street Cut Permits 960 Ple r TOWN OF SOUTH WINDSOR INSPECTION REPORT Cone.raC"tor R "'PAVING LLC Permit No. 4008 3 89 &D,,,STAGF. ROAD PLEASANT VALLEY 96dreAQ ::.:. , Location O96Q- PLEAS ZASTd1TBU Y CT''°A6033 Type Work MISCELLAN 3�hok� '.N6.:,(' A.) 3 :33C, s Y Date Insp Needed ---—__—---- — sr ?s Time Insp Needed _-- -- t y Inspected By P �h r 4 Work in Progress lw'J ► _ —r �y c �YeS q+•fJti °: :. . Permit No. 4008 Town of South Windsor, CT Date 06/08/2005 Street Excavation Permit Expiration Date 06/08/2006 .m...............,,,,.�T""' Descrip: OVERLAY SECTION OF PSF''R"Y Ik>•IL`'< RbbfT ORt< JTJ'T`TS.:;96'Q: 970 Applicant ' y ,< f LoI At y ion �. Name R & J PAVING LLCy £3 �aty pASf y Addr. 89 OLDE STAGE RPAD ;• F" v�; .o-•• r" GLASTONBURY CT�06033::" Work"*, LSCELLAN Phone (860)633-4933 , } � M a Applicant agrejs Q ' fi ` 'sYr the ? dUth Wlgd- a h .amount of bond required and to r0imburo,e 1he Town o Scffi A. ndsor an incurred by the Tdw o 'f Y"eft nses g. ..... ..;,.. ghn�ttaon with this permit and that applicarYfi:;•''. ' am :.kYM(t':;;.yg. :'.::,, by"'tlie rules and regulations for pee.m �;, as.,cu hF., . Cut Permit Manual. ' � 'Sr . � }S©utl iarii�dor s Street �h iF r FS.f * * PERMIT TO B 1Ci3 QN �»zL iIl�hS Issued by -- G� Date Completed ...✓'.; hE." ',.• ""•. • APPLICATION FOR STREET EXCAVATION PERMIT 410 a TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 n FEE $25.00 b 3 3 —83 3 K £J PAvj�L L ". Name of Firm Phone No. 1, Z3 —443,j Address of Firm 99 %rwcn-r jL/1 CIL 06073 Location of proposed work Describe fully nature of permit requested o`C '&tneo 0-r rF VA"Ir s 60 -9 le Starting date Approx.time for completion Z Call Before You Dig No._/ D O- 1 ZL_y tl r Traffic Services Control No. Show sketch of proposed work or furnish two copies of separate drawing indicate North This section to be filled out by Town of South Windsor Pavement Cut (� No.cuts �01 Est.Size of Perm.Patch(s) Est.Pvt.Thickness in. q y" Est.Unit Price$ L v Amt.of Deposit$ f AW+ Total Due$ by N ( )Cash( )Check# a , Permanent Patch J No. Cuts � _ Size of Patch(s) Final Billing $ Amt.Due Payee Amt.Due Town $ 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 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: b �3I d� Date: Title: Driver's License#: f W V U-27 PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES