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HomeMy WebLinkAboutStreet Cut Permit 90 Scott Drive 900092 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 07/20/09 GIS ID: 81600090 s �_ - FEE: 25.00 MUNIS APPLICATION# 200900839 � IRATION DATE: 07/20/10 APPLICAN, G 3 ��� � � I LOCATION NAME: AIROLDI'S INC. = RFC �8 Si 016 DRIVE ADDRESS: P O BOX 71 STEVEN ISSA&PATRICIA W SOUTH WINDSOR, 50# § O*DRIVE Jor z PHONEY 3 INDSOR,CT 06074 �t WORK DESCRIPTION: DRAE APPLICANT AGREES TO FURNISH THE �" Fi�pv ! jT ' bND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANtIC TFVIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE IClL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS O TLINED IN THE TOWN OF JDSK' T I" U IT MANUAL. ISSUED BY DATE INSPECTED INSPECTED BY 7/20/200911:20AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** i TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT-NO.: ' 000 9 a CONTRACTOR: 'S LOCATION: p � TYPE OF WORK: �-O i A)a --DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK jN -PROGRESS: - AS-BUILT: INPUT: DATE:,_ (� WJ2007 Town of South Windsor INpSECTION REPORT 07 gooq O83 7 APPLICATION FOR STREET EXCAVATION PERMIT Ict 92212- TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 \ FEE $25.00 Name of Firm ��� c� 5 ��'�- Phone No. Address of Firm .moo �l 1 ' ��av �C o bo r1 �-)- Location of proposed work ©10 Describe fully nature of permit requested Starting date \`l ® Approx. time for completion Call Before You Dig No. Traffic Services Control No. Show sketch of proposed work or furnish This section to be filled out by I two copies of separate drawing Indicate North Town of South Windsor Pavement Cut No.cuts VA 0 Est. Size of Perm. Patch(s) I 2 b Est. Pvt.Thickness in. Est. Unit Price$ Amt.of Deposit$ s 8 Total Due$ by I i ( )Cash( )Check# RCN Permanent Patch No. Cuts j Size of Patch(s) )F- -- `�,tb -'-�—� Final Billing ---� $ I Amt. Due Payee i $ Amt. Due Town i By Applicant is responsible for contacting Date the Police Dept. and C.B.Y.D. 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 TLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed:—��:,� Date: �� b Title- (:773, a\ Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES