HomeMy WebLinkAboutDriveway Street Cut Permits 73 Wood Pond TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3943 Co'3traet ,r BR
WOOD POND ROAD EWER PY'S�:I.NG, LLC
Location 0073 a '''`'
Atd de 22 "PH SF T'>I ;IL DRIVE
Type Work DRIVEWAY >" "2; 06107
Date I n sP Ne
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# ti Permit No. 3943 Town of South Windsor, CT
Date 04/18/2005 Street Excavation Permit
Expiration Date 04/18/2006
Descrip: £`
Applicant lo`ca`tion
Name BREWER PAVING, PLC „Qi7° WQS T,pNpO'A3a
Addr. 22 PHEASANT HIIrL DRIVE:.
WEST HART FORD,;"GT. "i'
: Q 6`1'0 3
Phone (860)521-6942 #
y;
Applicant agrees t`o fur ,isk the"''Zrrith Windsax.the amount of bond
required and to rimbur5 ,:.iaFie Tow
Lb> f'; :.<,' ia;llsor X ".lenses
incurred b the
T
Oi ni:z:
W f,br}'' ' `'�"
s. :.<si::;aC ion this
,..,:..... ..... . :...... '�.::�' .... co'nrieet with
permit and that appl mane'"'"Y 'Ea.,..mil ar,..,Fw thand"'"w.i; "':' rle;: the rules
y, t, and
regulations for permits ag otxinecT � '
ut or s Street
Cut P � n of .SQ 3z.Wind,
ermit Manual. :`a "" }f ""`'"
PERMITSTLF{,A. r'J.Lli'':"
s:
Issued by rcV
T,i�1 e
Date Completed
�. APPLICA11ON FOR STREET EXCAVATION PERMIT �_QL
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1840 SULUVAN AVENUE
SOUTH WINOSOk CT 06074
FEE $25.00
Name of Firm__ w� 9(A v 10®), L C C Phone No. 0
Address of Fkm ox J-'7 I i of R Ali-+4- e-T I i,!A Z
Location cf proposed work
Describe fully nature of permit request c y 114 U)IJ
Starting date 3 Approx,time for completion_ as
Call Before You Dig No., 7 ,b r:) o �c` TrWiic Services Control No.
Show sketch of proposed work or IbMish This
two ooPles of separate dr swing Indksab North u Ian to mouth
knoAlt o
re�wrt of m thr�1 iNlndear
Pavement Cut
No.cats
7SEst.Size of Penn.P&Ws)
Eat.rv.Thickneas in.
Est.Unit Price i
Arnt.of Deposit E
Total Due$ by
( )Cash( )Check
Panwient Patch
No. Cub
Sks of Patch(s)
— �FMa1 awnip
Amt.Due Payee
Amt.Due Town
By
Applicant Is responsible for contacting Date
the Poke Deot.and C.S.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 t AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMIT10#E TtiE N OF SOUTH W1NLISOR"8 STREET CUT PER T LIAL.
11
Signed: Dats:& /
Tit e: Driver's License M
PERNT SHALL BE KEPT ON JOBSITE AT ALL TIMES