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HomeMy WebLinkAboutStreet Cut Permit 35 Gail Lane 1000052 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 04/07/10 , GIS ID:34500035 - FEE: 25.00 MUNIS APPLICATION# 201000345 TION DATE: 04/07/11 APPLI A C N s OCATION NAME: AIROLDI'S INC. ANE ADDRESS: P O BOX 71 AS-O PETER M JR& SOUTH WINDSOR, 0 E O TI-L INDSOR,CT 06074 PHONE WORK DESCRIPTION: REM E. LEAVE APRON. APPLICANT AGREES TO FURNISH THE TO O ND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY BY MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE I 3 LL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SO S U RMIT MANUAL. ISSUEI5JBY DATE INSPECTED INSPECTED BY 4/7/201012:11PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: / 5 CONTRACTOR: A ), LOCATION: q ' ) a h--P_ TYPE OF WORK: Y 1 V e (.JGt . DATE INSP NEEDED: DATE INSP: INSPECTED BY: 3 D WORK IN PROGRESS: Lak SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: C DATE: ao " V W/2007 Town of South Windsor INPSECTION REPORT 07 _,261 o,o 5 3qS APPLICATION FOR STREET EXCAVATION PERMIT /00 00&.2 TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00 Name of Firm V�Ver Phone No.? 06 ©'q3 Address of Firm .w 0�®, Location of proposed work_ Describe fully nature of permit requested Starting date Approx. time for completion o d Call Before You Dig No. 20 16 �t Z� Traffic Services Control No. Show sketch of proposed work or furnish This section to be filled out by y two copies of separate drawing Indicate North Town of South Windsor Pavement Cut 0 No.cuts Est.Size of Perm. Patch(s) Est. Pvt.Thickness in. ficoo� Est.Unit Price$ Amt.of Deposit$ Total Due$ by ( )Cash( 4heck# f Permanent Patch No. Cuts Size of Patch(s) Final Billing 7-- Amt. Due Payee Y )y_,X"0- - Amt. Due Town By 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 PERMITS AS OUT LINED I E TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Dater Title: Driver's License# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES