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HomeMy WebLinkAboutDriveway Street Cut Permits 453 Foster S 800037 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 04/11/08 GIS ID: 33600453 � F EEMUNIS APPLICATION# 200800425 25.00 RTIONDATE: 04/1 1/09 APPLIC ANT r fir,.• NAME: AIR OLD ' INC. I S ,{:�.>�� LOCATION �.�, : `..s�::.ti RE . ADDRES STREET OX 71 ' . SOU TH H � LION JJLIEN&L YND A WI NDSOR, SO R v Cl44T� 4. � .�°FEZ STREET,... Q,S ' ET }�. H WIIDSO PHO ���>�..t" R CT 06074 WO RK RK DE SCRIPTION:SC RIP TI O N: D ,.1 RI V� AP PLICANT I CA N T AGR EES E ST O F UR NI S HT HE hx� ��' Qi�TH'., }j' ;A3'. THE TOWN OF SOUTH WINDSOR FOR ANY tXPF SES'ui:� :'< ,' $ INTENANCE OR SQUIRED AND TO REIMBURSE IN CONNECTION WITH THIS PERMIT AND THE A-PPLIABIDE BY THE RULES AIND REGU ATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SC J1IT€ SR, pE IT MANUAL. Wvl— ISSUED BY ``F Z C DATE INSPECTED INSPECTED BY 4/11/2008 10:31 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: s rc)m3 l CONTRACTOR: \ I ` LOCATION: TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BY: �t> WORK IN PROGRESS: AS-BUILT: INPUT: DATE: W/2007 Town of South Windsor INPSECTION REPORT 07 APPLICATION FOR STREET EXCAVATION PERMIT. 600031 TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm ���� -�- Phone No. � Address of Firm n w ,.>���,�r O b©`� Location of proposed work 4-5 3 Describe fully nature of permit requested Starting date �A i5 Approx. time for completion Call Before You Dig No. Traffic Services Control No. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor Pavement Cut No.cuts Est. Size of Perm. Patch(s) Est. Pvt.Thickness in. Est. Unit Price$ v Amt.of Deposit$ t b Total Due$ by ( )Cash( )Check# Permanent Patch No. Cuts Size of Patch(s) 183 Final Billing Amt. Due Payee Amt. Due Town By Applicant is responsible for contacting Date the Police Dept. and C.B.Y.D. 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 INED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed Date: Title: Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES