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HomeMy WebLinkAboutStreet Cut Permit 477 Foster Street TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 4259 Con tr,a.at.6f" STq'»'2�QjgjATES, INC. ,' DAY INC. Location 0477 FOSTER STREET Z.,-6,3 C/O,II Y:..:STr` a:..LLC. Type Work MISCELLAN Rx O. BOX, 7 . f<;• ✓.' Yoh... «F;:'. �:�— G'- AW d) �G 9' e Date InsP Needed - M' k>'e , at • Time Insp Needed n'0+ ;, "y e •? "`;'".;g>s'.':, ----��--- •<—:,,.fir=— t 3`�:1Re`'.I r»: Inspected B Work in Progress _..�• --��--,T�s� �_W� ('F±!✓1�"`` , ��'>�:',rie�yk`�,"xiv�:n>i� a=4.M�,, �" . : �'. ' _ Permit No. 4259 Town of South Windsor, CT Date 97/26/2006 Street Excavation Permit Expiration Date 07/26/2007 .. Descrip: EXCAVATE TO INSTAL.li-WADER"`&%;:SEGC A l i PP Ldc&; 1 inn Name STI ASSOCIATES, NC.'"` Addr. C/O DAY-STI, LL0Wn . VERNON CT 06066; V. ' Phone (508)943-4104 ... _ sum._ Applicant agreesF. "W the Tcaxwm= `��x`Zu?"t:h Winc d `'tl$et aR1o: nt of bond required and to reimbutfse>.:t*c. a` w 4 :,hrtiu .iY°;for ft' h::a3 ;expe3�ses incurred b the Tow . ^ . 3'2: 'r ;..x �,., s: Y 4 m 5> t _anvi-' ir � ::_ri rhYnecti n with this permit and that appl c,,W t Y,6-4- i A f> n:: :yE}�' ','`the rules and regulations for permits as, f:tXt` iiY` cS sbr's Street Cut Permit Manual. �i '•,z" �'e>: .:g `�.:, `'ey�„"�:`�;;a`: may,:' ;;�' < * * PERMIT TO''3 rit .P .,OBY t`"<AF1;;zTIME5. Issued by xiI .i � ---_---C-------- V — — ------------- Date Completed _-- _— —_ Inspected 'By APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm S -f/ LL Phone No. k"O SS ff ?f! Address of Firm 0 I'S �7 V K R �!v ( �4 p�©�� � Location of proposed work ec V.e j,, .Describe fully nature of permit requested &V A t l,� , Starting date_ / t ) o (o Approx. time for completion e.�e Call Before You Dig No. ao K Traffic Services Control No. Show sketch of proposed work or fumish two copies of separate drawing Indicate North Thls section to be filled out by Town of South Windsor Pavement Cut No.cuts k Q s3UME- s' S1:OAQ.A►t,iJ Est.Size of Perm.Patch(s) I' QA"rCA Est.Pvt.Thickness- in. Est.Unit Price Amt.of Deposit$_v,I-51p, Total Due$ ,f ,®� by ( )Cash( )Check# . Permanent Patch No. Cuts Size of Patch(s) Final Billing Amt.Due Payee Amt.Due Town By Applicant is responsible for contactin the Police De t.and C.B.Y.D. Date 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 OUTLINE IN THE jOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: ` Date: �/�C/�G Title:_ Driver's License#: G tp PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES TOWN OF SOUTH WINDSOR ENGINEERING DEPARTMENT ADDRESS PERMIT NO._ SHEET UTILITIES OF INSPECTOR TEMP.PATCH DATE INSPECTOR COMPLETION DATE COMPUTATION SHEET