HomeMy WebLinkAboutDriveway Street Cut Permits 59 Stanley D 1
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4004
Location 0059 STANLEY DRIVE : ntractox E,C;a.9AVINC,,
Type Work DRIVEWAY Are' ' i "< 13ST
ANCFiSTE Cfi 06040
Ph,�ne .NQ
Date Insp Needed
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Time Insp Needed ----- — --
Inspected By
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Work in Progress Qn —
Input
Date "`i—
Permit No. 4004 Town of South Windsor, CT
Date 06/02/2005 Street Excavation Permit
Expiration Date 06/02/2006
Descrip:
Applicant
4Qp.at1on
xi
Name E.C.PAVING 5 STANXEY O IVE
Addr. 139 WETHERELL S.
MANCHESTER CT Gj'6040 1 p o Wof DRIVEWAY
Phone (860)647-9834
oUt Wia-dsApplicant agreds to the � W 'q eamount of bond
required and to rOimburse' the'town of: Sq�iC hdsor fax aziy 'expenses
incurred by the Towr} fCr inazzzteexxaxt e riF Te& X worg h,'Cohne, ti on with this
permit and that applicant ss anvil a owl-, .:•and, Ifl, e rules and
regulations for per'ii:G's';a<s''queue: ><.:s.xi'€: :h. ?:>:;T' ::.. .. .4x�c�..r>f ScsuCh Wirti3 or s Street
Cut Permit
Manu
al.
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* * PERMIT Tf3 BE KEPT ON.iT Ek SaTZ At g..LL T.IM S
Issued by ---------
_ Title
Date Completed "'"'
n��vr�.Hfflulu rvK 51 KEET EXCAVATION PERMIT V60 Ir
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
y�.� FEE $25.00
Name of Firm ti_ I �oa o AJ6 aih Jl� I /A �A f'
Address of Firm - s "J dlgl)
Location of proposed work R �S ygA11N / �.�
Describe fully nature of permit requested �G ����� �>
-PNiJ t — �� 77 �i Lit �r 1
Starting date
Call Before You D" No.r��O Approx.time for completion
b� Q 7 Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out b
Town of South Windsor
Pavement Cut
No.cuts
0 Est Size of Perm.Patch(s)
Est Pvt Thickness in,
Est Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check#_
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt Due Payee
$
AmL Due Town
By
Applicant is responsible for contacting
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 S UTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: �
Date: of lL
Titte:
Driver's License#:
PERMIT SHALL RF KFPT nN.rnPcjT= A,-^a,
M&S PAYING AND SEALING INC.
435 Buckland Road 6 5pringoide Avenue
MING AND SEALING South Windsor CT 06074 Danbury,GT 06510 Toil Free-1-500-456-5EAL
INC. 1 (560)645-1915 (203)790-9727 Email:saleoPmooealcoat.corn
Fax:(560)645-4602 Fax:(203)794-9172 www.mcreaicoat.com