HomeMy WebLinkAboutDriveway Street Cut Permits 52 Stedman C TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3762
Location 0052 STEDMAN CIRCLE Conk. :aC't'ti'rATI2T7:L:;.:S INC.
Type Work DRIVEWAY Addrg s is O '$p .: 71
SOUTH W::IpTDSpR' CT 06074
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Date Insp Needed
Time Insp Needed
------- Time Ip . C,k
Inspected ByTRW
3
Work in Progress
Input
Permit No. 3762 Town of South Windsor, CT
Date 06/14/2004 Street Excavation Permit
Expiration Date 06/14/2005
Descrip:
Applicant Locat::ion
Name AIROLDI'S INC. OP SEI7MAN CIIt�LE
Addr. P 0 BOX 71
SOUTH WINDSOR CT 0:6:074 Tt*T�� q Woxk 1JRZ�TEWAY
Phone (860)289-3876
Applicant agrees to, fvrrizSh: the Town cs .: 'gtiC,h Windsor tlie' amdxnt of bond
required and to reimburse the 'Sown q;f S4zith �l3ridsor for dny :;expenses
incurred by the Town!.,fioriimazndenanc re ezx +ork ';n ecsnnectidn with this
permit and that appliGa:nt 1' amili'ar wYt3i and w311 akarle b4.y the rules and
regulations for permits"'as out;lihed :� 3 Y Tt *n rf Spu;th Windsor s Street
Cut Permit Manual.
* * PERMIT TO BE KEPT 0ld, pB ''SI1 AT ELT ;TMES
Issued byTitle _ v
r►
Date Completed _---_—_—__-- "" Inspected B fx��
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1S40 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $2S.00
Name of Firm�i��
Address of Firm Phone No.
Location of proposed work
Describe fully nature of permit requested
Starting date I -N
Call Before You Dig No.: - Approx.time for completion _ \N
Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out b Town of South Windsor
two copies of separate drawing
Pavement C!�
Indicate North —
Prop. size of cut
No. cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
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:
Title: \c�c, '
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc