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HomeMy WebLinkAboutDriveway Street Cut Permits 15 Scantic M d (' l TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 4139 Location Conti•;act-pr"Hd'VA'C;::GDNSTRUCTION G R Address a 297 "F# �T, S'T12EET Type Work Dkj;0 D.A. NBURI 00<1,0 l one, Date Insp Needed ----------- Date Time Insp Needed ---------- T'1,in. Ia Inspected By ------ Wo rk in Progress _p a-a --_— j - a ----- --------- - ------ _�,....,_iz. © (0KCJ P Permit No. 4139 Town of South Windsor, CT Date 01/11/2006 Street Excavation Permit Expiration Date 01/11/2007 Descrip: CONSTRUCT DRIVEWY h `PUMP• S.T7{PLODI Applicant Location Name KOVAC CONSTRUCTL N pQ1 SCANTIC MEADOW`R Addr. 297 WHITE STREET DANBURY, CT 068I0a I�IVEWAY Phone (203) 743-4022 Applicant agrees to furi3�s ;.the �o�an'¢f St�l t 3 Wind or the u aMont of bond required and to reimblir"se ,the Tows ScsuhTrdax:fv7r any erspenses incurr ed b the Town. Y f:o;r'.it�a=� :t��anc:eor with this permi t and th at at a c a'n p � t PP � � � m �z.ar ��.�,�a �u� wYyl abi$e by the rules and regulations for permits as outlznea* an thei South W ndS'or's Street Cut Permit Manual. * * PERMIT TO'"$. APa',.,ON'><TaI3.,;i .. >}ST,...,•A'E.:;T 'MRS. Is sued d b J i Y / Date Completed Inspected B rf APPLICATION FOR STREET EXCAVATION PERMIT 4139 TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of firm �� ���' " �,� a.J Phone No._ 2' —7 5 3"5eo d Address of Firm 9 CJ h r .S- Location of proposed work_ e � CAj C44 c Describe fully nature of permit requested C Z's ✓ A) J�C� 2t Starting dat ( Approx,time for completion__—�f (j61 Call Before You Dig No. �CA� Traffic Services Control No. Show sketch of proposed work or furnish two copies of separate drawing Indicate North This section filled out by Town of South Windsor Pavement Cut No.cuts 0 Est.Size of Perm.Patch(s) Est.Pvt.Thickness in. Est. Unit Price$ Amt.of Deposit$ 'j Total Due$ by ( )Cash( )Check# Permanent Patch 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. 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: in1 Title: Af--e Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES