HomeMy WebLinkAboutStreet Cut Permit 40 Valley View Drive 900072 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 07/07/09 .
GIS ID: 91200040
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FEE: 25.00MUNIS APPLICATION# 200900763 ,'
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X TION DATE: 07/07/10
APPLICANT Ka
--�--NAME: AIROLDI'S INC. LOCATION
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s { 40 ALLL;Y VIEW DRIVE
ADDRESS: P O BOX 71 DE-AN`�E ROLAND L JR&JOYCE R
SOUTH WINDSOR T�fO x h
' " ALDY VIEW DR
PHONE SOR,CT 06074
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WORK DESCRIPTION:
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APPLICANT AGREES TO FURNISH THE T .. T < :
: T, �B ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI� . P 1V 1INCt O ,IAINTENANCE OR REPAIR WORK IN
,.
CONNECTION WITH THIS PERMIT AND THE '.1 J�; L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S
I I ' TRREI�CT P PIT MANUAL
ISSUED BY DATE INSPECTED INSPECTED BY
7/7/20093:09PM *** PERMIT TO B KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WIHDSOa INSPECTION REPORT
PERMIT-NO.:,_iQkll-- CONTRACTOR:
LOCATION: L4
TYPE OF WORK: T)� v-e Lop
..DATE INSP NEEDED:
DATE INSP: f&i
INSPECTED BY: ( P
WORK JN
-PROGRESS:_ '� � . - Sxe rtl
AS-BUILT:
INPUT: DATE: Q
W/2007 Town or South Windsor INPSECMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
` FEE $25.00
Name of Firm \���c��.a �--'V�- Phone No.
Address of Firm C""C O b��>>+
Location of proposed work
Describe fully nature of permit requested
Starung date Approx. time for completion
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish This section to be#i11ed out by
two copies of separate drawing Indicate North Town of South Windsor
Ll 0Pavement Cut
No.cuts
Est. Size of Perm. Patch(s)
i
Est. Pvt.Thickness in.
Est. Unit Price$
j Amt.of Deposit$
`19 Total Due$ by
I
Cash( )Check#
i
iPermanent Patch
No. Cuts
i
i Size of Patch(s)
$Final Billing
Amt. Due Payee
i $
i
i Amt. Due Town
$
BY
j 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 UTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed Date: �q
Title: Q5 Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES