HomeMy WebLinkAboutDriveway Street Cut Permits 200 Scantic TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4140 Con,r;raCEor KOVAC C`ON:S,TRUCTION
Location i#,* TIC MEADOW R A�dress 297 �THISE STREET
Type Work DRIVEWAY
I .URY;° 'CT 0681.0
P one TTO 4,' C 374;3 $Q22
Date Insp Needed
---------- Date Tnsp
Time Insp Needed
Inspected By
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Work in Progress —�_lrl•<-S }�-���� � �w� � �-.,r�� .
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Permit No. 4140 Town of South Windsor, CT
Date 01/11/2006 Street Excavation Permit
Expiration Date 01/11/2007 "
Descrip: CONSTRUCT DRIVEWY FOR P:UM1 ;S:TA 1':*>I
Applicant Locat' trn
Name KOVAC CONSTRUCTI6N0
t3 SCANTIC';MEADOW R
Addr. 297 WHITE STREET
DANBURY, CT 06810 Type gfvrk T7R7EW1Y
Phone (203) 743-4022
Applicant agrees to furrsl.sh.the Tpwk7 ,Grf Ft} t Wind�{�p tk�e a ount of bond
required and to reimbu'r�e th.e �TOWT1. f Sou�.h : la;}.:p f� aify e p nses
incurred by the Town:. tor itt&-' rnan'c'e"or>':re' "� r> w�3rk,>a
P with this
permi
t and
tha
t a 1'.
r
PP � fir,:>:w;�_��t:; aiat�('�as•�'1:. 3'a:e by :the rules and
regulations for permits as CiuG fined €gWzl, bf SquGh iiiids'or's Street
Cut Permit Manu
al.
* * PERMIT TO $E..TCIP : . ili :AT AI ',.TIM S.
Issued by
Date Completed Inspected B
APPLICATION FOR STREET EXCAVATION PERMIT ��4-a
TOWN OF SOUTH WINDSOR Per-
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of firm V S 'e%-,v -�,J c�f Phone No. )t 3,
Address of Firm 5 e'�"ti d C
Location of proposed work -4,J f, 0`
Describe fully nature of permit requested (f'O^1�'�i2.t1z D.2,
Starting date ' " !(It 4)
Approx.time for completion_t---4,,
Call Before You Dig No..4o c:6, h*6 0 tV-7 Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out by
Town of South Windsor
Pavement Cut
No.cuts
0 Est.Size of Perm.Patch(s)
Est.Pvt.Thickness in.
Est.Unit Price$
S _A-) S �!L4,L 7 =.� ,Q"J
Amt.of Deposit$
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: �7
Title:_
Driver's License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES