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HomeMy WebLinkAboutDriveway Street Cut Permits 310 Strong R TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. //`/ C Location ontra' 'tor H. W. ,EVACK CO. I :SC:?LO R'O11D Type Work DRIVEWAY SOUTH WINDSOR C'I'..;.06074 P'hoxe.NQ {8i�:)..528 0331 Date Insp Needed _------_--_ ` Date Tip ^ Time Ins p Needed ---- ::: I. Inspected By y Work in Progress ' ©p .F, .. put gate Permit No. 4322 Town of South Windsor, CT Date 10/25/2006 Street Excavation Permit Expiration Date 10/25/2007 Descrip: INSTALL DRIVEWAY P« Applicant ac 3t 1 ail y. 3 f Name H. W. LEVACK CO 0348. STRONG Addr. 49 MASCOLO ROAD SOUTH WINDSOR CT 0. 074 T r e Q jr� R VEWAY, Phone (860)528-0131 ji! Applicant agrees to'fCzrn1 9h the Tcrw £yf Spu..th Windsor .the atrioiznt of bond required and to reimixrse tie,To�t11 X. cuh Wi1�dSbr. for ecpnses incurred b the Town;. "'} "''Y r. rgsc kt' anC. ..or: . . pair..;:t r5rlS: .ri' brine.cti:on permit and with this P tha t a h a try... ] .al�lde .by 'the rules and regulations for permits as:. out.:;ine'd S kh o of Sodtvi14 d.,s'or's Street Cut Permit Manual. N' * * PERMIT TO 'BE1T.. ,LA,. > ALA, Is sued ue d by Q Date Completed Inspected By 0`7 IUN t-UR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm L _ Address of Fir / �� Phone No. 6� Location of proposed work .Describe fully nature of permit requested Starting date Call Before You Dig No. Approx. time for completion Traffic Services Control No. Show sketch of proposed work or famish two copies of separate drawing This section tc be filled out by Indicate North Town of South indsor Pavement Cut No.cuts Est.-Size of Penn.Patch(s) Est PvL Thickness in. Est.Unit Price$ Amt of Deposit$ Total Due$ by ( )Cash( )Check# . Permanent Patch �� � � No. Cuts Size of Patch(s) Final Billing ` Amt.Due Payee Amt.Due Town By Applicant is re nsibie for contacting 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 TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE O TO R REPAIR CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS REIMBURSE THE PERMITS AS O TLINED IN THE TO N OF SOUTH WINDSOR STREET CUT PERMIT MANUAL. R WORK IN CATIONS FOR Signed: � Y Date: Title: Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT AL TIMES