HomeMy WebLinkAboutDriveway Street Cut Permits 135 Skyline TOWN OF SOUTH WIND OR INSPECTION REPORT
Permit No. 4059 Con;t.ra'ctor,AIROLD "'5;.;:.INC.
Location 0335 S Y3;7 EK �3jt VE Fiddress: P O AOF. '1
Type Work DRIVEWAY "' 'WrNDSOR CT, 06074
Piioa:e No"('& Q?2.69 '3876
Date Insp Needed -------- — Data'TYYp'
Time Insp Needed
Inspected By
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Permit No. 4059 Town of South Windsor, CT
Date 08/08/2005 Street Excavation Permit
Expiration Date 08/08/20 6
Descrip:
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Applicant Lacata.on
Name AIROLDI'S INC. f13S SIfYIA, E DRTYFs
Addr. P O BOX 71
SOUTH WINDSOR Ct 0 A7# Pee of Wox DRIVTBWAY
Phone (860)289-3876
Applicant agrees to f xrx sh they. ut;ki WindSGx tk e amo7ant of bond
required and to reimbu se the Town o£ South Tl�nosor fir any :expenses
incurred by the Town €' r'ma�nbenaTree ox repay .w.ork i:n connection with this
permit and that appic rit aSmil3ar 'ivit=h and s�za11 abide, by the rules and
regulations for per "'as Out d ned;,is3 U T€ n "v So h Windsor's Street
Cut Permit Manual.
PERMIT T, BE K pT QN. } *L A ATE TIMES '*
Issued by ---- —M
Date Completed _--- ---- " >:>:;;<,.:;<:;:Inaedt'ed By
APPLICATION FOR STREET EXCAVATION PERMIT y 05
TOWN OF SOUTH WINDSOR Permit No
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm! � ,;_ Phone No. W9` V3�Co
Address of Firm, � r-� �
Location of proposed work
Describe fully nature of permit requested
Starting date_ l-i -
Approx. time for completion - (j
Call Before You Dig No.c-k) QL I t om, Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out by
Town of South Windsor
(� Pavement Cut
mac` No.cuts
Est.Size of Perm. Patch(s)
- Est. Pvt.Thickness in,
Est. Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check#
t
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 De t.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 OFSOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed U
Date:_
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES