HomeMy WebLinkAboutDriveway Street Cut Permits 29 Robert Dr TOWN OF SOUTH WINDSOR INSPECTION REPORT
PerAt No. 4085 Cont,ra�'& AIROLDI"t"Sl<:,T;NC.
Location 0029 ROBERT DRIVE Adz.ess':>>: ''`>p 0QX. T7
Type Work DRIVEWAY SfUTHWINDS;OR C1 .:06074
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Permit No. 4085 Town of South Windsor, CT
Date 09/14/2005 Street Excavation Permit
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Expiration Date 09/14/2006
Descrip:
Applicant s t
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Name AIROLDI'S INC. 00,29,ROBERT 1JV1V.B
Addr. P 0 BOX 71
SOUTH WINDSOR CI 0,6074 Type. of Wdrk PRIVEMZty .'
Phone (860)289-3876
Applic
ant
a rees'':
f , slisll 'the644tl:; Wind6qk Ghe ,.amot}nt of bond
required and to reimbt se::i.) �o "q iS uGh Sri# tax fGk n 6 perises
incurred by the Town fps .maCeance 'or repair w�3' k 3,11 4Ctig11 with this
permi
t and th
at a lcaT'"
P pp � milr�r;;w��j� ���d �i.T1 abide: by the rules and
regulations for permits as out3'lnecl,i ''a, 'f So�itt Windsor's Street
Cut Permit
Man ual.
* * PERMIT TO 'B:F :FCkPT`DN at}£3::.:.. 2..Z: <:9t .',AIY3s::>T3'ME:S.
Issued b
Date Completed Inspected By "
APPLICATION FOR STREET EX
CAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm11 ��� P;,one No. �C
Address of Firm
IL
Location of proposed work
Describe fully nature of permit requested c
Starting date_ ��� \� �' ��� Approx.time for completion
Call Before You Dig No.,--*,),-,LN0 �',I:i , Traffic Services Control No. -
Show sketch ofproposed work or furnish
s
two copies of separate drawing To be filled out by Town of South Windsor
Indicate North Pavement Cut
Prop. size of cut
No. cuts
Amt. of Deposit$ by
()Cash()Check#
Cut size after Perm. Patch
No. Cuts
Final Billing $
�4 Amt. Due Payee$
Amt. Due Town $
Applicant is responsible for contacting
the Police Dept. and C.B.Y.D. by date
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: C!
Title:
D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc