HomeMy WebLinkAboutDriveway Street Cut Permits 85 Orchard H 800034 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DAT,,: 04/08/08
GIS ID: 66900085
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FEE:MUNIS APPLICATIO 25.0 N# 2008004 0
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NAME: M&S PA
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PHONE 860- - x <' R CT 06074
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APPLICANT AGREES TO FURNI
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SH THE T(�'VVI�;;�F SgU:'TH. '�.. ,,....>.„, ,ry :.:>::;,<..r3
., 3 ?a' tT ;.BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANYXPIV$ES'`INL�1p ;kIt„11�I'AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AR
CONNECTION T IS" ,4 T. WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF Sb€-hi- ? S R?S I RI E3 i T"PF IT MANUAL.
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ISSUED BY
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DA EF P, PECTED INSPECTED BY
4/8/200812:07PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 90003-A CONTRACTOR:
LOCATION: 95 pr c kaf- 1 g j I 1
TYPE OF WORK:_ "Dcx-�j
DATE INSP NEEDED: DATE INSP: Ar
INSPECTED BY:
WORK IN
PROGRESS: �ihk C.l4�q� �crt �c G.��IC az
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AS-BUILT:
INPUT: CO DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
Apr 08 08 11:38a 1 860 648 4602 p.2
APPLICATION FOR STREET EXCAVATION! PERMIT 9000 .1�
TOWN OF SOUTH WINDSOR Permit Na.
PUBLIC.WORKS-DEPARTMENT
TOWN HALL
1540-SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
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M&S Paving and S"Ing Inc: FEE $25.00
435 Bucidand Road
Name of Firm South Windsor, CT 06074 .
Phone No,
Address of Firm
Location of propos work S orch a re l
Describe fully nature of permit requested _
Starting date ! Approx.time for completion S o' .
Call Before You Dig No. / Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out by .
Town of South Windsor
Pavement Gut
No.cuts
Est:Size of Perm. Paws)
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Est.Pvt Thickness in. ..
Est.Unit Price$
Amt of Deposit$
.. Total Due$ by
)Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
S
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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THR TOWN OF SOUTH WINDSOR'S STREET CUT PER IT MANUAL.
Signed: �I Date. Z 0
Title:
Driver's License M
PERMIT S LL BE KEPT ON JOBSITE AT ALL TIMES