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HomeMy WebLinkAboutDriveway Street Cut Permits 128 Rosemary soob7o PERMIT NUMBER TOWN OF SOUTH W I N D S O R w STREET CUT PERMIT DATE: 05/22/08 ID: 77400128 GIS MUNIS APPL ICATIO �`� N# 2 008 0 730 <`�` FE E:E• :. .I T 25 .00.0 0 RA I O N DATE:T E• 0 5/22 A n. P 0 AP PLICANT I C A NT NA ME: E• M&S PAVING AND LOCATION OC �:. ION ADDRESS: 435 BUCROAD,:;;:­` KLAND < -EI ARY LANE SOUTH WINDSOR CTQ�< EkT P s1UL H&P :' 4� R°;: AR Y LA NE NE PHO NE 6 8 - 4 0 6 -8 1 9 1 fi U< fI WI N S O R CT 06 074 7 4 }i• WO RK RK DE SCRIPTION:S C RIP T I O D RI 1 aV .;F:<:::�''s'r.'.'..•Y'd:X rid PPLIC TA AG REES E S FURNISH THE .: THE TO WN OF SOUTH WII:< : NDSOR FOR ANY PS :.:r <<^> : ::BCTVD REQUIRED AND TO REIMBURSE CONNECTION WITH THIS PERMIT AND THE AI?PL10"A�T I ] „{ .A p, L SIDE BY THE MAINTENANCE OR REPAIR WORK IN FOR PERMITS AS OUTLINED IN THE TOWN OF SOUJH R; STRT Efi `; J � ;: � > VI$1 PERkIT MANUAL. RULES AND REGULATIONS ISSUED BY a At .. DATE INSPECTED 5/22/200811:00AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** INSPECTED BY TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: ©w CONTRACTOR: `"S �a �)►� LOCATION:_ l a V nSe rr)a(-u TYPE OF WORK: v-e,,,DQ DATE INSP NEEDED: DATE INSP: INSPECTED BY: EQ WORK IN PROGRESS: AS-BUILT: INPUT: L'1'w DATE: I 0 a W/2007 Town of South Windsor INPSECTION REPORT 07 APPLICATION FOR STREET EXCAVATION PERMIT boa 7 0 TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 M&S Paving and Sealing InFEE $25.00 435 Buckland Road Name of Firm South Windsor,CT:06074 Phone No. J(ao Address of Firm Location of proposed work Q J Describe fully nature of permit requested 64 Starting date Z Approx.time for completion Z Call Before You Dig No. $ aO 5-3 Traffic Services Control No. Shavi sketch of pro work or furnish two copies of separate drawing Indicate North This section to be filled out by Town of South Windsor Pavement Cut _ No.cuts Est.Size of Perna.Patch(s) �-! Est.Pvt.Thickness in. Est.Unit Price$ Z 1 ` Amt.of Deposit$ Total Due$ by I f L ( )Cash( )Check# i Permanent Patch No. Cuts Size of Patch(s) Final Billing Amt.Due Payee Amt.Due Town By. Applicant is responsible for contacting Date the Police Dept.and C.S.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 AN BY THE RULES AND REGULATIONS FOR PERMITS OUTLINED THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: /Z Title: P Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES