HomeMy WebLinkAboutDriveway Street Cut Permits 1105 Strong TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 4068
Contractor JACQt7BS Q.QNSTRUCTION (JOHN)
Location X�D
Pddre {.' 67 RIDGE<:Type Work DRIVEWAY
SOUTH WINDOR CT ,06074
Phone No:189)432 1'8.23
Date Insp Needed p � i
-----------_ Date in
Time Insp Needed
F.,
Inspected By
Work in Progress _——ULW .
Permit No. 4068 Town of South Windsor, CT
Date 08/23/2005 Street Excavation Permit
Expiration Date 08/23/2006
Descrip: CUT PAVEMENT FOR NEW' DVEW '"".'
Applicant ocaa` axl
Name JACQUES CONSTRUCTION 1�,*0 STRONG RQAD
Addr. 67 RIDGE ROAD
SOUTH WINDSOR CT 06074 'e bf:�G7t rk OR, EWAY
Phone (860)432-1823
Applicant agrees, to';furn",i the TQw4 of, tbbfli Windsor the aiiloCtnt of bond
required and
to re"'
T tan,rah �oubh Y7�.xdsar f�tr any perises
incurred by the Town. fear rtta rst�nance Or �p iY'wrh�k .n ..... tipn with this
permit ...
p and that appl3 c nt is <fat it^ W 'f,pi 31 b1e{e by the rules and
regulations for permits as 6ut:l1nec3 tii�; s 'of South d9`6r's Street
Cut Permit Manual.
* * PERMIT TO B$ '.KEPT OC7 vQ}3;a1TE °PT A1rL`;:;TiME5?
Issued by
Date Completed --- Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT o-6g
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm Phone No. „3
Address of Firm
Location of proposed work11001, f)e
Des ribe full nature of permit requested
Starting date a:.3 O S Approx. time for completion_ L--�{�S
Call Before You ig No. Traffic Services Control No. r
Show sketch of proposed work or famish
two copies of separate drawing Indicate North This section to be filled out by
Town of South Windsor
Pavement Cut
No.cuts
Est.Size of Perm.Patch(s)
Est.Pvt.Thickness in.
Est.Unit Price$
Amt.of Deposit$
Total Due
b$
y
( )Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
Amt. Due Town
By
Applicant is responsible for contacting Date
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 TO REIMBURSE THE
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTI WITH T S PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS TLI IN THE TOWN OF SOUTH WINDSOR'S STREET CUT P RMI MANUAL.
Signed: Date:
Title:
Driver's License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES