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HomeMy WebLinkAboutStreet Cut Permit 151 Pleasant Valley Ro TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit Flo. 4323 Contxa' 'Eor H. W"."""`FsE}V7�CK CO. Location 151 PLEASANT VALLEY ROAD ttdres ?} 49 MgSGLO titP,D Type Work WATER OUTH `fiNd 0 bZ 06074 yam"' Da te I P ns Needed ./ :'•.aC / = Time Insp Needed Inspected By ` � �"•r` }. _' , 3> :�;� j; 4_.:.' :� Work in Progress g In _ ,,D to Permit No. 4323 Town of South Windsor, CT Date 10/30/2006 w:r Street Excavation Permit ration Expi Date 10/30/2007 D e s c r 1 Applicant < t �� .. ':.E, ; #v<{;�:<' "i� Name H. W. LEVACK CO M.W- ASAN WU'AT:,LPY ROAD; Addr. 49 MASCOLO ROAD. ..� SOUTH WINDSOR Tf550 74 fi k T s a ' c5 'uPoY' T .. Phone (860)528-0131 Applicant agreed to^>fi' n .s the<.: `' ; . , ?.. + br`a:tlieb�a'ndunt of bond required and >h #`: t., 4 to �Y'FxSP�nses incurred by the Tow'% a 'it)$ 3%tpance rep ^ r`wor1 #4pp'nt .ton with this permit and that applicant is aYaia w dbide by the rules and CutuPermitsManuafor permits ag c5ut in, � lr y°gf S�kL�l ` T .ndsor's Street l. : * * PERMIT S"I PT*Off" E*ruT'FE"'T,...,A lY iloi . > Issued byn w J.0 .Date Completed _------- Inspected By �/: c -- APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm Address of Firm Phone No. Location of proposed work , Describe fully nature of permit requested Starting date - Call Before You Dig No. Traff . time for completion Traffic Services Control No. Show sketch of proposed work or furnish two copies of separate drawing Indicate North This section to be filled out by Town of South'Windsor / Pavement Cut No.cuts= _.._ Est.'Size of Perm.Patch(s) Est.Pvt.Thickness _in. // Est.Unit Price$ l U Z v Amt.of Deposit _— Total Due$ �_by ( )Cash( )Check#__ Permanent Patch No. Cuts I Size of Patch(s) Final BIIIing $ Amt.Due Payee Amt.Due Town By _ Applicant is responsible,for contacti qg the Police De t.and C.B.Y.D. Da 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 AS OU INED IN THE TOW OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed. Date: Title: Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES 1 1 1 11' I '1I• • 1 1 0 1 1 1 :000OOO�I O�Oo.000��mpg�'O�OOOOOOO■MO®a mom mom :000�eO i� uOO NEON OONONE O O: ■000®M®MO goalOOO!sOOOOOOOOOOOOO ■.00O�OONEON Omom OOI,O00NEON OOOOOOO :oo�OOO®�OOMEMO Omom OOOOOOOOOOOOOOOO OOOO■■®SEEN OOOOOOOOOOOOO®®OOOOOO ■so������®onoOeoO000■�.�®�®��������� OOOOOOOOIOOOOOOOOOOOO®OOOOOOO®OOO®®® ®®s00000!ooO00000000so��0000000O000®® ®■.0000a000O00000000O000000000®®�� ■���®����■�����■��■.oslO000000aO NEON o iie®iooOiooOO���®����©o�O■0000000s®�� soon®OO�iio■■o�00000r�oo■����������.� �■®o�oaf�OOiis�00000�®���®0000OO0000 L�OOOOOfiAOOOOOOOOOOOOOO OO00000�1OOOOl�I�J►OOOOO`�}O®OOOOOOOOOOO�i-_. �:®0000�,100■OG ``ll� �OO6�a �OOOO�O�OOOI�OO® OOOO eOO®e��OOO®off®OOrPs�� s®®Oo���®OO��®�■ OOO��OOOOO.�OOOO� -72 IOOOO�I��iOOlilO�tO OOOOOOO�I�OOOOOOO®OOOUO IOOOOOOOOO®1100�1 OOOOOOO���OOOO�IOOOOOOO�IOOOOOOOOO�fI®�O O0000000�oOOOooOOooeo�oOOOO00000®�,OOO ■OOO ■OOOOfioIOOOOOOOOOOUS mom onI/.00 ■oO 000so���■■ooO in ME 0 I►���■00000O���„ 000000sI000Ocoo■�� "IBM ON ■����■■�c00000000000�0�����0000O■��� ����®O00000■■��® moons OO OOOOO■OIiOOo �■®OOOOOOOOOOOO ■ SEEM looms ®000000��0000000 �000O���OOo■�®o®0000 oo®000®��®®®O000aooOOoo��®OOo®OO®®®.O�■■�■OOOIOOOOO000OOOO®OOOOOOOOOOOOOO■ ®OSOO loomOUunn ■OOOOOOO■oJOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOI �OOOOOOOOOOO� OOOOOOO�IOOOOOOOOOOOOOItoOOOOOOOOOOOO iOOO OOOOiOOI�OiOOO■OOO soMEMO :0000MEN OOoO®mom SSOOOOOOOO�O OoOOoiiomii o�n000OOOOOOOOOOOoo0Oso�o MENEMnsoMMONS soon ■ooOOOo�OOOOOOOiniooOOOOOOOOO■����® . , ooOOOOO�o®■oO0000