HomeMy WebLinkAboutDriveway Street Cut Permits 99 Tumblebro TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4006
Location ppgg 'B �Qnt`ractgr, AIRQ. DI'Y"5LE BROOK DRI :<,INC.
Type Work DRIVEWAY Addre. p O g 71
1T13SC7R C'I:., 06074
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Permit No. 4006 Town of South Windsor, CT
Date 06/06/2005 Street Excavation Permit
Expiration Date 06/06/2006 .
Descrip:
Applicantof
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Name AIROLDI IS INC. :y: 'Q'49fi� Mg
J I,P9.:.,KS? DR
Addr. P 0 BOX 7 1
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SOUTH WINDSOR `"'0`6
'WoY�. F9�i�V'EWAX
Phone (860)289-3876 .
Applicant a reed ,t.o`.ftirs'i"
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g a =:tr�e;:,2.;�.?:" ix. ��kt:...Win`so""`...:he:z� .o
�7� � ,� �� .,� .� m. unt of bond
required ass...
q ed and to ;;.reimburse.tFk :TowfrsS.tia r. €ptny expenses
incurred by the Towh 'f.fiax s'iatr�ara.c:�,: '.;;,. ,' i
r,Yx;., ..er ..� .connect€ion with this
permit and that a 1` cant ^``>'"
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P pp �. `is<;:�:aet�;;j,?�� �?`�iT�t.�r�' •":.:'"1-li.Y:' 'ab.a:de'...,b.. ::[he rules and
regulations for permits afs o�titlin2d fi}t ?�ipii# ,;bf;,Sct-,h sor's Street
Cut Permit Manual.
* * PERMIT TO "AE: K'EP' Q�I<:JOB""S"Z"T. A'i AI li' T,`MES.
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Issued b
Y T
Date Completed Inspected B
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm --, \ ` Phone No. �
Address of
Location of ps work ropo
Describe fully nature of permit requested
Starting date --) Approx.time for completion
Call Before You Dig No Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North �' Prop. size of cut
v lGszc
No.cuts
a- Amt. of Deposit$ by
Cash O Check#
Cut size after Perm. Patch
No. Cuts
'�- Final Billing$
--2� Amt. Due Payee$
1
'� Amt. Due Town $
Applicant is responsi `'f r co taEtfng C' 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 WINDSOR'S STREET CUT PERMIT MANUAL.
i-
Signed:
Date:
Title: D.L.#•
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES