HomeMy WebLinkAboutStreet Cut Permit 835 John Fitch Blvd 800152 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT (PUBLIC UTILITY
DATE: 08/28/08
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GIS ID:47700835 y]:.,.
FEE: 00
MUMS APPLICATION# 200801344 � k >.
:y tXIRATION DATE:
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APPLICANT >�. ••<.:.�.f.�
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NAME: METROPOLITAN DSI aS635 JOHI"T FITCH BLVD
ADDRESS: 125 MAXIM ROAD r �
. LPTtYCYNTHIA
HARTFORD CT 061
A WHITER WIND CT
A � . � 41 ? ODST�CK,GA 30189
PHONE
WORK DESCRIPTION: INS
APPLICANT AGREES TO FURNISH THE FQOFT R E"P,Iy IND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EX SSI3fQ ,. TTFMAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH9'0; C 1 T¢I k2 i TT ND LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFS J. STfUrf IT MANUAL.
ISSUE BY MTE INSPECTED INSPECTED BY
8/28/200811:59AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 00 CONTRACTOR: M C
LOCATION:
'IYPE OF WORK:_ -e
-=-==--- = DATE iNSP NEEDED: DATE INSP:-4/Z _o_39
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INSPECTED BY: ti
WORK IN
PROGRESS: f.-,)o-- cY
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- - AS-BUILT:
INPUT: G DATE:
W/2007 Town of South Windsor INPSEMON REPORT 07
Y
THE METROPOLITAN DISTRICT- PAVEMENT CUT DATE: 20'0 U
C-4 f .T S' BILL JOB YES k6 NO❑ WO# 5 2 S 3
DRESS �� jobi pI*tZ -I 1 w TOWN �5VVM VOW STATE HIGHWAY YES NO❑
DRAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND CUT MADE IN
M CA SECTION OF PAVEMENT STREET BIT.CONC. D CONCRETE ❑ PREMIX ❑
o MCASIDEWALK BIT.GONG. O CONCRETE 37 FLAG ❑
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CURB BIT CONE, 0 CONCRETE Cl STONE ❑
DRIVEWAY BIT.GONG. ❑ CONCRETE ❑
GRASS yto/im AfCC-009
REASON FOR CUT:
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NUMBER OF CUTS:
DATE OF FIRST GUT:_ D - 10 0�j
p! IS JOB COMPLETED: YES NOK y
FOREMAN;
IQ,D REPLACEMENT PAVEMENT CONTRACT NO.:
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BIT.GONG. ❑ CONCRETE 0 PREMIX ❑
DATE COMPLETED:
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ACCOUNT-NUMBER:
CALCULATIONS
o OF CUT ITEM# ITEM# IT" EMS ITEM
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PRESS HARD 3 COPIES PAvrN(3INSP OPERATIONS UTILITY SERVICES CONTRACTOR
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