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PERMITNUMBER TOWN OF SOUTH WINDSOR, CT
DATE: 09/15/08 .'"`> STREET CUT PERMIT
GIS ID:3360072
MUNIS APPLI CATION# 200
801439 FEE
:
25
.00.0 0
EXPIRATION DATE:
APPLICANT y 09/l s/o9
NAME: AIROLDI'S INC. ' s .:LOCATION
ADDRESS: P O BOX 71 v SRS 720 FOS1 ER STREET
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SOUTH SOR 5 ` '.... aIEI <• TtIA CAM
WIND T>Oii(J7. ILY TRUST
PHONE f
? 1 F(75T R STREET
4 OUxH WINDSOR,CT 06074
WORK DESCRIPTION: f
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APPLICANT AGREES TO FURNISH THE T0WW0F S.0.UTI {
THE TOWN OF SOUTH WINDS0R FOR ANIF. S AMdU�TT QF BDND REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE p5C'L ;I :<'�oV ::�012>IVIAINTENANCE OR REPAIR WORK IN
tI'tT`ls t: I; fH. NbTLL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF REED CXJT PERMIT MANUAL.
ISSUED BY A
DA E INSPECTED ~
INSPECTED BY
9/15/20083:32PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I �— OR. N�CONTRACTOR: of iD cA `
) .S
LOCATION:__ ' -
TYPE OF WORK:_
DATE INSP NEEDED: DATE INSP: %D�a edd
INSPECTED BY: -RD
WORK IN
PROGRESS:__ tt Na
AS-BUILT:
INPUT: DATE: (,
W/2007 Town of South Windsor INPSEC 7ON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT.
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $26.00 C �
Name of Firm S^�—�.�'� Phone No. 3$ 6
Address of Firm _O_ + `� ��� �'��� so�c 4 v 6� 1�
Location of proposed work _ `122-0 F05 16 /L 6-7—
Describe fully nature of permit requested
Starting date /U To, Approx. time for completion /b 4'
Call Before You Dig No.,;2CO931- 666 7a- Traffic Services Control No.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
�--�---- Pavement Cut
2 i No.cuts
Est. Size of Perm. Patch(s)
Est. Pvt.Thickness in.
Est. Unit Price$
Amt. of Deposit$
Total Due$ by
I ( )Cash( )Check#
i llo
Permanent Patch
No. Cuts
Size of Patch(s)
i�t ; Final Billing
$
$t. Due Payee
I
Amt. Due Town
$
21 ' 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 OUTLINED IN HE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:'it Date: L?17)0
Title: } .Le_ Driver's License#: Ft L
14
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES