HomeMy WebLinkAboutDriveway Street Cut Permits 28 Stanley D TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3, 3. Contractor AIROLDI 'S INC.
Location _ Address 41 ZINFANDEL CIRCLE
Type Work DRIVEWAY TOLLAND CT 06084
ne No. (860)896-0401
Date I nsp Needed <n at dog
Time I nsp Needed
Inspected By
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Work in Progress
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� � Date
PertiNo. 3413 Town of South Windsor, CT
Date '. 10/07/2002 Street Excavation Permit
Expiration Date 10/07/2003
Descrip: CK 7057 2 PERMITS
Applicant N S 1, Location
Name AIROLDi ' S INC. 6TA. EY DRIVE
Addr. 41 ZINFANDEL CIRCL
TOLLAND CT 06084 DRIVEWAY
Phone (860)896-0401
Applicant agrees
t
n sor the amount of bond
required and to rei b T ut � or any expenses
incurred by the Tow ns t ep n connection with this
'permit and that app i h a bide by the rules and
regulations for permit T o uth Windsor's Street
Cut Permit Manual . M ..
W I It 2!
* PERMIT O LL TIMES.
p
Issued by
Date Completed Inspected By.
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSORf CT
FEE $25.00
Name of Firm ,
Address of Firm Phone No. ` � G
Location of proposed work
Describe fully nature of permit requested
Starting date 0 o�-
Call Before You Dig No.000 LL Approx.time for completion o'a-
Traffic Services Control No.
Show sketch of proposed work or furnish two copies of separate drawing To be filled out by Town of South Windsor
Indicate North Pavement C
Prop. size of cut
No.cuts
Amt.of Deposit$ by
( )Cash ()Check#
Cut size after Perm. Patch
No. Cuts
V.� Final Billing$
Amt. Due Payee$
r
Amt. Due Town$
Applicant is responsible for contacting A
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: �,
!„ Date: l d2_
Title: —
D.L.#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc