HomeMy WebLinkAboutStreet Cut Permit 60 Hayes Road 800068 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/19/08
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GIS ID:40200060
FEE: 25.00
MUNIS APPLICATION# 200800696 �TION DATE: 05/19/09
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APPLICANT % fit. 'LOCATION
NAME: AIROLDI'S INC. '4 S. z`` AYES- OAD
ADDRESS: P O BOX 71 1 3 's ; ;x y �``
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SOUTH WINDSOR,C 7�k � `,7 'E GOAD
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PHONE
WORK DESCRIPTION: DRIV - ANNED
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APPLICANT AGREES TO FURNISH THE TO*VNV, .41TH, :0 O }. REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY `I`. ' +. "'.3; kCO .<' TNTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE PLgQ N 1``I > A Ib T AND iL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S .T� R "SE � iI'T MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
5/19/200810:08AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 30006 ' CONTRACTOR: 4-\\f cal oQ 1 ' S
LOCATION: (o 0 A&qp-_,S J�
TYPE OF WORK: � t-;
DATE INSP NEEDED: DATE INSP: I z 1a o'8
INSPECTED BY: Gh
WORK IN
PROGRESS: L o o > S off. 'N a
AS-BUILT:
INPUT:__ DATE:
SCANNED
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT. E 000L c
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25A0
Name of Firm �����,- s��-��- Phone No.
Address of Firm -
Location of proposed work
Describe fully nature of permit requested ace r�� '�•aew tam
Starting date `� z' Approx. time for completion `� w
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish Indicate North This section to be filled out by
two copies of separate drawing Town of South Windsor
Pavement Cut
No.cuts
��Qj 0 Est. Size of Perm. Patch(s)
Est. Pvt.Thickness in.
Est.Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check#
Permanent Patch
No. Cuts
'ab
Size of Patch(s)
Final Billing
Amt. Due Payee
$
Amt. Due Town
SCANNED
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
PERMIT LINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: S��'�\og
Title: G Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES