HomeMy WebLinkAboutDriveway Street Cut Permits 21 Sunset Te TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3526 Coat<r'actor CUSTOM° P.AVING
Location 0021 SUNSET TERRACE Address JOHAt F,'JURG'ELAS
Type Work DRIVEWAY P.;,,Q B`OX 178
QUTH ;WI:NDSQR .CT"a06074
L?hone''No $;60)528: 2`684
Date Insp Needed _--__--- Dste I9p
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Time Insp Needed $P
Inspected By --
Work in Progress
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• Permit No. 3526 Town of South Windsor, CT
Date 06/11/2003 Street Excavation Permit
Expiration Date 06/10/2004
Descrip:
Applicant ' Loe'aton
Name CUSTOM PAVING 021 SUNSET :TTERRACE
Addr. JOHN F JURGELAS
SOUTH WINDSOR 'M :0,6074 ?�pe o£ #T8-rk;DRIV WAY
Phone (860)528-2684
Applicant agrees to. urnish the Towiti''a Sa th Windsor the amount of bond
required and to rep mbu'rse the Tawx2' 'Sp;ttth Windsor„ or any expenses
incurred by the Town,:,'or maintenance :::repair woxk 1tt `Cnl3ect: on with this
permit and that applit'ant ;1a< famlliax' h anti w11.1.>::abide by the rules and
regulations for permits as `r�utlined i .he ToST�,of ,south <klindsor's Street
Cut Permit Manual
* * PERMIT TO,BE kEPT ON JOB' SITE'AT �YLL TI;1ES.
Issued by _ o �Q _ _ Title
Date Completed _ �___ Inspected By _ ___
Locater nest- 20032401921
From: <CallCenter@CBYD2.com>
To: <cbyd@southwindsor.org>
Date: 6/11/03 9:26AM
Subject: Locate Request- 20032401921
(CALL BEFORE YOU DIG-CT) 06/11/2003 09:29:35
-5G -C4 -CW -GV
-OT 4-SW SWINDS -T5
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*****ROUTINE*****
TIME..09:29 DATE..06/11/2003
REQUEST NO...20032401921
LATITUDE..41.8466548 LONGITUDE..-72.5561523
TOWN......SOUTH WINDSOR f
ADDRESS...21 STREET....SUNSET TER
NEAREST
CROSS STREET.-AYERS RD
-----------------------------------------------------------
TYPE OF WORK.....EXC TO REMOVE& REPL DRIVEWAYS
AREA IS MARKED...YES
REMARKS:
WORKING OVER THE EXISTING DRIVEWAY FROM ST TO GARAGE
---------------------------------------------------------
START DATE......06/16/2003 START TIME..07:00
CALLER..........JOHN JURGELAS
CALL BACK.......8-5
PHONE#.........860-528-2684
FAX#...........
ALT. PHONE#....
EMAIL ADDRESS...
CONTRACTOR......CUSTOM PAVING
ADDRESS.........15 CHAPEL RD
CITY............SOUTH WINDSOR
STATE...........CT
ZIP.............06074
-- - -- -- -- - -
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EXCAVATOR DOING WORK.-SAME
ISSUED TO: DATE: TIME: BY:
DATEITIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
i
APPLICATION FOR STREET
EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm f✓ a .�
Address of Firm Phone No,
Location of proposed work
B,r•j f' e 7
Desaibe fully nature of permit requested
Starting date `) o-&/
Call Before You Dig No. �FP* cra�aprxnY t�;;,e F
�- ,��.� w�npieaon
Traffic Services.Control No.
Show sketch of proposed work or furnish
two Copies of separate drawing o be fled out by Town of South dsor
Indicate North Pave` m �
Prop.size of cut
No.arts
Amt.of Deposit$ by
()Cash()Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
$
Applicant is responsible for contacting Amt. Due Town
the Police De and C.B.Y.D. by
date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BONA UI
� N�R FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAI(YTENANCE OR REPAIR WORK IN
PERMIT AND THAT I AM FAMILIAR � RED AND TO REIMBURSE THE TOWN OF
TOWN OF
R"5 STREET CUT PERMIT WITH AND WILL.ABIDE BY THE RULES AND REGULATIONSFOR PERMIOTS AS OUTLINED NTHIS
MANUAL. THE
SOUTH WINDSO
Signed:_
✓ Date:
PERMIT SHALL BE KEPT ON 7OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit•doc
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