HomeMy WebLinkAboutDriveway Street Cut Permits 229 Benedict 800153 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/04/08
GIS ID: 09600229
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MUNIS APPLICATION# 200801374 .% .,>` . 25.00
ARATION DATE: 09/04/09
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NAME: AIROLDI S INC. �:. �'3j:?`>�_:>
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ADDRESS: P O BOX 71 ' ,aC3I ZCT 'DAVID M&SHARON F
SOUTH WINDSOR
DICT DRIVE
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SO CT 06074
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WORK DESCRIPTION: "'` ". k
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APPLICANT AGREES TO FURNISH THE TOW �pF'S. U1fI
{ � T VF B(3ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY•EXP. L INC,
I-�� ,�F':;1~DW�rOff.. �AAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE ASP.Y IC,A 'IS< t TH;:t1 TT3 V `Y L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF -aft"' V i3S€ 'S STREET,C JI p1yI MIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
9/4/200811:46AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION:
TYPE OF WORK:
--- -DATE INSP NEEDED:
----- DATE INSP:
INSPECTED BY:_glj
WORK IN
PROGRESS:
AS-BUILT:
INPUT: DATE:-
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT,
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
,a FEE $25.00
Name of Firm C ` \``r � ��L.�'�- Phone No.
Address of Firm _O , + `1 \ c ov VJ',N\t>, soc , � I
Location of proposed works E.h l
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Describe fully nature of permit requested
Starting date 1216 g Approx. time for completion 9
Call Before You Dig No. a 064 3 O Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
0 No.cuts
Est.Size of Perm. Patch(s)
Est. Pvt. Thickness in.
Est. Unit Price$
Amt.of Deposit$
Total Due$ by
2-
( )Cash( )Check#
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.B.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 I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLNFq IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: <r- Date:
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JO SITE AT ALL TIMES