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HomeMy WebLinkAboutMiscellaneous Street Cut Permits 119 Sky f TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3712 Contract'dr"'ANISR'E;-;CHARBONNEAU & SONS Location 0119 SKYLINE DRIVE Ad r:Q.s:S; 125 >.E'DWI:N ROAD Type Work MISCELLAN SOUTH 'WINDSOR ,":CT 06074 Phone<No ( ) Date Insp Needed � ' �'` Dates Time Insp Needed -------=— Tamp Inspected By — --� ✓ Work in Progress 17 _ ------ -0q --Input � Date — Permit No. 3712 Date 05/19/2004 Town of South Windsor, CT Expiration Date 05/19/2005 Street Excavation Permit Descrip: SIEWALK REPLACEMENT Applijcant Location Name ANDRE CHARBONNEAU & Sc?NS Addr. 125 EDWIN ROAD pli9 SHI'L:IIE DRtV$ SOUTH WINDSOR, Phone f, Work MS•S CE�,LAN Applicant agrges Go fur th required and theh own o wn of .S u h windse the<a aunt of to reimburse. incurred by the To f south NPttdsor f4'f an' bond permit and wn for malnenance ,fir r y expea�ses that applica t, pa wa:rk in::,�onneCClon with this regulations miszr.:.wztT3',:and �zz>llbde b for permits >as 04t1 n I., theed T y the rules and Cut Permit Manual. awn o. South c€so'r s Street * PERMIT TO 'BE KEPT ON tTfY$ 5I PT AT ALL TIMES Issued by f _ �.c ---- — T1 t I.e. �> n' Date Completed f — -- By I, r Permit No. 3712 Town of South Windsor, CT Date 05/19/2004 Street Excavation Permit Expiration Date 05/19/2005 Descrip: SIEWALK REPLACEMENT A41icant LgcattGn Name ANDRE CHARBONNEAiJ & SONS ©�19 SKYLINE DRIVE, Addr. 125 EDWIN, ROAD SOUTH WINDSOR Tyke '4;foxJ RSTSCLLAT7 Phone Applicant agrees; to furxi sh..the Town: cif 5O'uCh Windsor`:ahe ,amount of bond required and to reimburs8 the Taw# of _butte S�:andsgr, fbx any expenses incurred by the Town for mn�Xtt0nan�e br'' tepa'i''r work,,: ixz O'nrkection with this permit and that appliaxht s;s fami; is k1 b71„and wzT7, bide by tie rules and regulations for permits as outlinedh."the Town of SpuCh Wz,ndsor's Street Cut Permit Manual. * * PERMIT TO BB KIPS„ ON :IOB ALX 7IM58. Issued by Tithe f. r;- i Date Completed, Inspected B TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm qY _ Address of Firm 1 °Z � phone No. Location of proposed work C� Describe fully nature of permit requested i' 1C Y Starting date `4 1 J Call Before You Dig No. Approx.time for completion Traffic Services Control No. Show sketch of proposed work or furnish two copies of separate drawing Indicate North This section to I%e rifled out b Town of south Windsor Pavement Cut 0 No.cuts U Est.Size of Perm. Patch(s) Est.Pvt.Thickness in. n i Est.Unit Price$ Amt.of Deposit$_ Total Due$ 1 by - d (-416ash( )Check# Permanent Patch No. Cuts Size of Patch(s) ---- - - Final Billing Amt.Due Payee Amt.Due Town Applicant is responsible for contacting By the Police Dept.and C.B.Y.D. Date 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: L/ Date: +I c v v I Title: e v, Driver's License#: '1 G 3 3 0 p 3 PERMIT SHALL BE KEPT ON JOBSITE AT ALL IMES