HomeMy WebLinkAboutDriveway Street Cut Permits 7 Case Hill (2) 800085 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/10/08 :,.g'.;:• , of
GIS ID: 17700007
FEE: 25.00
MUNIS APPLICATION# 200800849 MO.i kATION DATE: 06/10/09
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APPLICANT LOCATION
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NAME: AIROLDI S INC. L CIRCLE
ADDR
ESS: P O BOX 71
R R?�ffl`(r' S G G R RE O Y A&BRENDA T
SOUTH
WINDSOR CT 06: 14.�
CIRCLE
I A SOR CT 06074
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ONE
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WORK DES
CRIPTION: DRI F
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APPLIC
ANT AGREES
TO FURNIS
H THE TO >F.SO.'„TH', "':.M
`�I*1';�'t. T�.:...„.,: ;5 �1' `'A....,(�I�I�1'I'.C�F;;BQND REQUIRED AND TO REIMBURSE
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THE TOWN OF SOUTH WINDSOR FOR ANY YPEI S S'fN TJR aWN`F: R' 2AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AFPL-K�kf Ik-PA14�I Ts� -wr-TH iF:ND WII`L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S0'vXH S fJ .: '�5 E T' i T'PE "IT MANUAL.
ISSUED BY T DATE INSPECTED INSPECTED BY
6/10/20081:53PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: add CONTRACTOR:
LOCATION: I I C ( (Z -
TYPE OF WORK: \ )a4
DATE INSP NEEDED: DATE INSP: iz 4-5��
INSPECTED BY: D
WORK IN
PROGRESS:
S, e lu,I k
AS-BUILT:
INPUT: C yy"__ DATE: I . 6
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT e?o W
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
_ FEE $25.00
Name of Firm �`<�� �Nc Phone No.
Address of Firm o y
Location of proposed work
Describe fully nature of permit requested
Starting date faS Og Approx. time for completion �3 Wks
Call Before You Dig No. �b®�`a�QQ o'�.`� Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
Est. Size of Perm. Patch(s)
Est. Pvt.Thickness in.
Est. Unit Price$
ap Amt.of Deposit$
1, I Total Due$ by
I'a.' , ��" ( )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=EDTHE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: b ��
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES