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HomeMy WebLinkAboutDriveway Street Cut Permits 20 Sharon Dr .a j. I TOWN OF SOUTH WINDSOR INSPECTION REPO i.RT Permit No. 4249 Cone; aetor QUALITY RAVING CO. Location Atldres 194 5,. MAIN 'S:TREET Type Work DRIVEWAY uAST WINBacOR C .., 06088 Pho4e No {.8��),523 47 8.2 f Date Insp Needed --------------- Date Insp : i Time Insp Needed ---------- Tiztle Inspected By _ --- � Work in Progress _— a y._e —_ e„ r + :S TT Permit No. 4249 Town of South Windsor, CT Date 06/30/2006 Street Excavation Permit i Expiration Date 06/30/2007 Descrip: i i Applicant Loatio Name QUALITY PAVING C' Q©20 SHARON I}RZV Addr. 194 S. MAIN STR0ET EAST WINDSOR CT ;06068 T��e Fkf P�of1€ RRTfiTRY1AY. Phone (860)523-4182 Applicant agrees toUznlsh.'the To'wr :zaf Soiitla Windox `:the amount of bond. required and to reiiburse't.hcowt ouch 'tafirar,. for aiiy expenses incurred by the Tow�i, cr mautdaance or' repair erork;'inoincti.in with this permit and that applicant is ,€ai3za wlt a3c} will:. abice by the rules and regulations for permits as otatline'a:;' e.'. ?ia ,of Sput. 4pdsor's Street Cut Permit Manual. * * PERMIT TO SE KEPT ON'JOB:.: ITE`'AT AD'L. TAMES. Issued by --- — '��/iTia Title Date Completed ------_—__-- Inspected By ��. APPLICATION FOR STREET EXCAVATION. PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT F�ermlt No. TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm Address of Firm �v Phone No.��� Location of proposed work te �� .Describe fully nature of permit requested Starting date Call Before You Dig No. APProx. time for completion Traffic Services Control No. Show sketch of proposed work or famish two copies of separate drawing Indicate North This section to be filled out b Town of South'V indsor Pavement Cut No.cuts Est.Size of Perm.Patch(s) Est.Pvt.Thickness in. Est.Unit Price$ Amt.of Deposit$ Total Due$ by ( )Cash( )Check# Permanent Patch o. Cuts a Size of Patch(s) Final Billing Amt.Due Payee Amt.Due Town A plicant is res onsible for contactingBy the Police De t.and C.B.Y.D, EDat I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWNS ONR MAINTENANCE ED AND TO REIMBURSE THE CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULE PERMITS AS OUTLINED IN THE TOWN T SO NANCE OR REPAIR WORK IN SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. SAND REGULATIONS FOR Signed: Title: Date: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Driver's License#: