HomeMy WebLinkAboutDriveway Street Cut Permits 62 Elizabeth 800049 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
04/24/08 �� r
GIS ID:
30000062 xitr
MUNIS APPLICATION# E:200800527 25.00
IRAT ION DATE:
04/24/09
APP L I A N T:=
NAME: M&S PAVING S w > OCATION
AND I AFIN .I . '''' S.
ADDRESS:
435 BUC :;;:::<;:;':;:' .....;: s6 ;.: LIZA l STREET
KLAND ROAD
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<.... '' �1�1�' �<IB�NO J
&OFELIA M
SOUTH WINDSOR
A$ TH ST
PH
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NE +:. II�dD- S O R 86 - C 0 T 64 0 8 60 1 74
9 15
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WORK
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1�DESCRIPTION:
.:.RIV F W.�Y
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APPLICANT AGREES ES TO FURNISH THE TCWN< ? w`
THE TOWN OF S >.. QITH::: k3MOiTI '0 ::1 'OI RE SOUTH WINDSOR FOR ANY`1XI1SN£T "`.:>' QUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE tI'P I .N T+ S, LRV I A D LLABIDE BANCE Y THE OR REPAIR WORK IN
"� RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SQT,�T£T IN�3SIR';S`STitE1K�'�i�T`��R1��fI'T MANUAL.
ISSUED BY DATE INSPECTED
INSPECTED BY
4/24/200812:14PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_Rew V 9 CONTRACTOR:
LOCATION: f I S
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: w o$
INSPECTED BY:-
WORK IN
PROGRESS: �,Z,e .
Po S'A
AS-BUILT:
INPUT: �,7> DATE:_ &3/ n 0
WJ2007 Town of South Windsor INPSECTION REPORT 07
APPLtCATiON, FOR STREET EXCAi/ATtON P"ERMIT
TOWN.OF SOUTH WlNDSOR
Perrn�#No
PUBLIC WORKS QEPARTMENT
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SOUTHIVIr,�N SQR 06074� r y x ,&-- -
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Name.of Firm Sotnh W��tdsor � � Phone No: �_ f_-"I,�-,l__-;.,,�--,.,�,.,"_,-_,"1;_-_,�,�w%1-'_,--'1,_���'�,-��,�I-�`;Z,'"�1,�i,�;,--_--��_�,-,_.---..,_;,__��`,�,�-�F',�--1'-,�-,r-,,�I-.1---",.
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Address of Firm x
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Location'of proposed work �.2
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Desc ibe fully nature of perr-'t reques#e ! _,. y9
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Starting date G A pproX time for rnpletion 2 ✓`
Call Before You Dig No. p(� dw Traffic=Services Gontrol_No. _- .
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Show sketch of proposed work or furnish This section to be filled out(bv F
two copies of separate drawing Indicate North Town of'South Windsor
Pavement CuT - .s ' X s
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NO CUtSr k ' 9.t,
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Est Size of Perm Patch(s)
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'` Est.Pvt ThtGkness m
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t , : ; Y t , Esf Unit Price$ I
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Amt of Deposit$. , y `
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Total Due;$ by
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t ( <)Cash-( )Check#
- Permanent Patch `
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No Cuts ,_
Size of Patch(s)
w9
Fin,a Billing
- 2
N _ ,
` Am£Due_Payee
3
3 _ , ;
Amt.Due Town
By
Applicant is responsible'for contacfing "
the Police Dept.and C:B.Y.D:
Date
I AGREE TO.FURNISH 70 THE TOWN OF SOUTH 1NINDSOR THE AMOUNT OF BOMDI"REQUIRED AND TO`REIMBURSE TlE r
TOWN OF SOUTH WINDSOR'FOR:,,, EXPENSES INCURRED BY THE"TOWN FOk MAINTENANCE OR"REPAIR.WORK INr�"
CONNECTION WITH THlS PERMIT AND THAT 1"AM.FAMICIAR WITH AND WILL ABIDE BY THE RULES".AND.REGULATI_M ,I,_R L, ;� "
_'PERMITS AS OUTLIN IN THE TO N OF.SOUTH WIND$OR S BTREET.GUT PE MIT ANUAL: _
Signed:
j , Date.
,.0
Title: l' Driver's License#. L
PERMIT SH L BE KEPT ON JOBSITE AT ALL TIMES `mob "
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