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HomeMy WebLinkAboutDriveway Street Cut Permits 1005 Strong e TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3299 Contractor CUSTOM PAVING Location 1005 qT C ;, , ` Address JOHN F JURGELAS Type Work DRIVEWAY P.O. BOX 178 SOUTH WINDSOR CT 06074 (860)528-2684 Date Insp Needed leg s 2 Time Insp Needed l Inspected By Work in Progress k " e 5 ► �`�L Date '1131 0 Permit Nbf. "99 Town of South Windsor, CT Date 05/23/2002 Street Excavation Permit Expiration Date 05/23/2003 Descr ip c App 1 i cant " Location Name CUSTOM PAVING a t Addr. JOHNS JURGELAS S R ROAD SOUTH WINDSOR CT 0 0 - 11 Phone (860)528-2684 ° ? DRIVEWAY Applicant agrees h n - ► iffd or the amount of bond required and to reim u o ' th jr any ex incurred by the Town ' e an pai ' i expenses Permit and that app 1 i a '� ,r, connection with this an � i de by the rules and regulations for permi 1 f th Windsor's Street Cut Permit Manual ". t * * PERMIT T LL TIMES. Issued byC- a Date Completed Inspected By 'ham,,.,. . J, APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR . PUBLIC WORKS DEPARTMENT TOWN HALL 1S40 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $2S.00 Name of Firm G 5 To J-+-, P14 V Phone No. Address of Firm ©� /. ? J,, , 6 L/ Location of proposed work_ /a n �-' _S"'9• �--o �� Describe fully nature of permit requested a �. Starting date Rpp-ou,time for cor �Ation Call Before You Dig No. Traffic Services Control No. Show sketch of proposed work or furnish two copies of separate drawing To be filled out by Town of shut Windsor Indicate North ��to u.f cerement Prop. Cut size of cut No.au Amt of Deposit$ �, O Cash O Check Cut size after Penn. Patch No. Cuts Final Billing$ Amt Due Payee$ Amt 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 WINDSO<'S STREET CUT PERMIT MANUAL Signed: Date: Title:_ D.L.#• PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES