HomeMy WebLinkAboutDriveway Street Cut Permits 58 Edgewood 800060 / '' TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/02/08
GIS ID:29400058
FEE:
MUNIS AP a <;:<;:q.PLICATION# 200800594
25.00
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TI��P<I�A O N DATE: 05/02/09
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APPLICANT
OC-,, ow"I NAME: M&S PAV ING AND S� t�, �N�'.IIaI'
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:. ,E . :.5, : 8�.�.� OOD DRIVE
ADDRESS: 435 BUCKLAND ROAD''" . 3::;;"
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SOUTH WINDSOR >;
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"< EDbOD DRIV
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WIN SOR CT 06074
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SCRIPTION:
C RIP TIO N: t
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APPL
ICANT
CA NT AGR
EES
S TO FU
RNISH
RNI SH THE Cd� Ix
FOU>
, ,;t? t� �LI�1T Q�'::k3(?1VD REQUIRED AND:;� # Q TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPH'$fS`' CLII -ly.' V�I�-W- RXAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AI' I T A 3I IS r At �r V"Itl AI>lpWILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SN',TH' IZr;S,TR: `TLI=PIIT MANUAL.
I UED BY
DAT INSPECTED INSPECTED BY
5/2/200811:28AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1R0DC 6 n CONTRACTOR: wvk Qa U 1 n
LOCATION:
TYPE OF WORK: a-
DATE INSP NEEDED: DATE INSP: )lb
INSPECTED BY: �
WORK IN
PROGRESS: L
0 5; ,.
AS-BUILT:
INPUT: C- DATE:
W/2007 Town of South Windsor INPSEMON REPORT 07
t" r -
APPLICATION FOR STREET EXCAVATION PERI�ILIT y.
TOWN'OF SOUTH ININDSOR 'PerrnrfNo x
PUBLIC WORKS DEPARTMENT `
TOWN HAL! >�,I
1540:SULLNAN AVENUE
SOUTH WINDSOR CT 06074 a
M&S Pays artd FEE $25.00 f z t J
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e 7-""fiF ?
Name of Firm SuGklfintl - ,44 -` .<; ,�,
1.
x Phone1No h
Address of Firm - b
x .
. y
Location of proposed work - '
. _;
S
Describe fully nature of ermit request d 1 j
"„ 1' "'
Starting date t Approz trine fog complefion ' _�
1
Call Befor`e,You Dig No f1" 4' /.fi�(} f Traffic Services Confcol,No a r 'z ' h
Showsketch of proposed.work or fi�mrsh
two copies of Separate drawing This section-to be filled out`bv
Indicate North
Town"of South-wndsor
-
"-"°" Pavement Cut
1
-
-V No cuts`. f *.
f <4 s
Est.Srz6 of Pem Patch(s) r,
l P`v
EsL Pvt 1 hickness h
o € - 3F
Pnce_$- rf»
Esf Unrt y
j
Amt of Deposit$ £- 1
Total Due$ by1.
1`/1a Y
Permanent Patch _
,
,,;-
,
Ni Cuts
Size of Pafch(s)
Final Brllrng
$ z "
Arnt Due=_Payee
Arrt Due.Town
III
'!
By
a
Applicant is responsible'for contacting f ,
.
1.the Police De t and C B at
Y.D..
. ,,,,.
efL�D E
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1:AGREE TO FURNI1.SH TO,THE TOWN OF SOUTH WINDSOR THE AMOUNT„OF BOND REQCIIRED RND TO REIMBURSE THE
TOWN OF SOUTH WINDSOR FOR-ANY'EXPENSES lNC:URRED:BY THE TOWN FOR MAIIf—trITENANCE_OR'REPAIR WORK`IN
CONNECTION VNITH.THIS'PERMIT AND'THQT I AM FAMILIAi WITH AND'WILL ABIDE BY THERULES AND REGULATIONS FOR
PERMITS A UTLINED THE TOW F SOUTH VV NDSOR`S STREET CUT PERMIT MANUr4L
Signed: `
r
Dale.-
Title
Dnver's License#.
PERMIT SHALL BE KEPT. W JOBSITE AT ALL TIMES