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HomeMy WebLinkAboutDriveway Street Cut Permits 164 Skyline (2) r✓ t r �o vrm /z/z 16 "_ _- ---- TOWN OF SO TH WINDSOR INSPECTION REPORT Permit No. 01 Contractor BLUE DIAMOND PAVING INC Location Address 1064 EAST ST NORTH Type Work , P.O. BOX 273 SUFFIELD, CT 06078 Mt Phone No. (800 )728-4644 Date Insp Needed bate Insp. L Time Insp Needed Insp. Inspected By Work in Progress 7i9 �a Input Date �rmit' No. 3201 Town of South Windsor, CT Datep - " . 09/12/2001 Street Excavation Permit Expiration Date 09/12/2002 Descrip; REPLACE DRIVEWAY Applicant Location Name BLUE DIAMOND PAVING INS � 1,64 'SKYLINE DRIVE Addr. 1064 EAST ST NORTH SUPFIELD, CT 06076 Type 4f W'o 'rk = DRIVEWAY Phone (800)728-4644 Applicant agrees to furn h ljhb 1 ►n df louth-Windsor the amount of bond required and to reimburse,,,,,iTown rsir:= cii"i 1hdsrr far any expenses incurred by the Town © rma `t+ana �e,ar repairrcrk; in connection with this permit and that appl icatntt .: ami 1-, 4-'t- by the rules and regulations for permil♦a as rail i t � Tows ,',South Windsor' s Street ut Permit Manual . * * PERMIT T` 8 r KEPT;°CJ ;� ;�T ``AT; ALA 'TIMES. _ VE�� Q� , �6 Issued by � � ° ,Titfie Date Completed IrY'spectedBy APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT. TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm ( ` Phone No. Address of Firm 3 ,e Location of proposed work r- Describe fully nature of permit requested Starting date Apprcm time for completion 9�r�c1�4iS Cali Before You Di No. ! Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate drawing G0.r7yl Q Pavement Cut Indicate No i Prop.�e of cut No.arts 10' t�o ..Amt.of Deposit$ by O Cash(�)Chedc# Cut size after Perm. Patch No. Cuts Final Billing$ AmL Due Payee AmL Due Town$ Applicant is responsible for contacting by 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: 17tie• D.L#: PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Pennit.doc