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HomeMy WebLinkAboutDriveway Street Cut Permits 81 Scott Dri TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 4080 Cont:rad o":r .HOMEOWN'ER:,.;,. Location 0081 SCOTT DRIVE Type Work DRIVEWAY SALE AS "ABfdVE: SY113TH W'IIDSOi�:. CT O'S,074 P...hiozi6 No ('tl40?b0©. 0000., Date Insp Needed Date Time Insp Needed ': Tame Irig �c. Inspected By 1 y,. Work in Progress I n""' �] Permit No. 4080 Town of South Windsor, CT Date 09/12/2005 Street Excavation Permit Expiration Date 09/12/2006 Descrip: REPLACE DRIVE Applicant Locat7o Name HOMEOWNER 60 1 SCOTT Dk.IVE F. Addr. SAME AS ABOVE : SOUTH WINDSOR C .0§074 i,: 3Xy0e a;f Wcxrc bR11AY Phone (000)000-0000 Applicant agrees to frr1 s11 the Taz1 SCY17 f Wind8ax :fie, artoTint of bond required and to reitib;ur$e the Ion a puth k9 Wdsbr fix ;.expenses incurred by the Towil.. " m ::a''`a.:k anc ""tir'Yepa "r"t ti 7c,;:: ;�<' a1 nection with this per mit and that a PP ,s :�ainsl�.��.:.:m�,.�:ti � ;G� W3,I1...Elbxd� ley 'th'e rules and regulations for permits as.. out:. ined7 air ':thei'EbwA o'f South Wa ndsbr's Street Cut Permit Manual. * * PERMIT TO';$,E ITE:,.AT„AI,i :YTIMES. Is sued d b oor P / Date Completed _—_--- ---- Inspected By APPLICATIOWFOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm ��cy� Phone No, Address of Firm Location of proposed work X4 , 6,4j (Q JUr Describe fully nature of permit requested A f—t vc25 Starting date S!�f v7fl1J Approx.time for completion Call Before You Dig No. Traffic Services Control No. Show sketch of proposed work or fumish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor Pavement Cut No.cuts 4:�2 Est.Size of Perm. Patch(s) Est. Pvt.Thickness in. Est. Unit Price$ e511 Amt.of Deposit$ Total Due$ by ( )Cash( )Check# Permanent Patch r � .Na. 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 9,UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: - Date: Title: Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES