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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3591
Location 0056 SCOTT DRIVE Cont r Ct'or AIRbtDI S INC.
Addre s ,.'
ii
Type Work DRIVEWAY 41 LINFAND'h"'Ii,. CIRCLE
OLLAND C 0 6 0`$:4
Phanz 0,401'
Date Insp Needed
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Time Insp Needed
Inspected By
Work in Progress
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Input
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'Permit No. 3591 Town of South Windsor, CT
Date 09/12/2003 Street Excavation Permit
Expiration Date 09/11/2004
Descrip: CK 7581 - 2 PERMITS
Applicant or-
;,.a,,ion
Name AIROLDI'S INC. 0t?S;E� $CO3.T DRIVE
Addr. 41 ZINFANDEL CIRCLE
TOLLAND CT 060,64 T ?1j.e WcTA DR:I.V8WAY
Phone (860)896-0401
Applicant agre0s to furhljshri the :T:izw off; otigth wihdscar the &mount of bond
required and to reimburse the''Town c?f South td �dsor fob any,,. expenses
incurred by the Town for,.ma�xitear� e; or ropaar work ih canzk .ct 'on with this
permit and that applicant zS 'f;amiliar x:t and 'xll ab'lde by t;)ie rules and
regulations for permit` aS o tt7 Yzted' 1 Y tkr Town i:;bf South Windsor's Street
.. ................ .. ...
Cut Permit Manual.
* * PERMIi::iab $,$..KEPT ON kT($ EI1E AT ALI, "I..IMES:
Issued by _--ef -�s� Titie ,"_ _
Date Completed _ ���1 TSn- — I>n gCCted Bri
C\��L
k APPLICATION FOR STREET EXCAVATION PERMIT 3s'�
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm ��`c��.; s ��.a�• Phone No.
Address of Firm
T
Location of proposed work S k. Sc;
Describe fully nature of permit requested
Starting date C:\\\ 0 3 Approx. time for completion
Call Before You Dig Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No. cuts O
0 Est. Size of Perm. Patch(s)
Est. Pvt.Thickness in.
1 l7A(Ac�L Est. Unit Price$
Amt. of Deposit$ O
Total Due$ by
( )Cash( )Check#
�S-I 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:���o 3
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES