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HomeMy WebLinkAboutdriveway Street Cut Permit 16 Ash Road 1000057 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 04/13/10 " GIS ID:05700016 FEE: 25.00 MUNIS APPLICATION# 201000379 _ TION DATE: 04/13/11. APPLICAN = OCATION NAME: M&S PAVING AND S AD ADDRESS: 435 BUCKLAND RO R S JOHN E&ELLEN M SOUTH WINDSOR, - yI AD H SOR,CT 06074 PHONE 860-648-1915 WORK DESCRIPTION: REM O AN g s E APPLICANT AGREES TO FURNISH THE TO O ,: OND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE AP ILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SO RMIT MANUAL. ISSUEb BY DATE INSPECTED INSPECTED BY 4/1 3/20 1 0 2:02PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO. I MOS 7 CONTRACTOR: I�rI Pau (� LOCATION: TYPE OF WORK: `f DATE INSP NEEDED: DATE INSP: INSPECTED BY: 200 WORK IN PROGRESS:- !�IoA_L Lc,ak. Ok SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: 1- /y- ) W/2007 Town of South Windsor INPSECTION REPORT 07 ©o? � "APPLICATION FOR STREET EXCAVATIQN PERMIT 4 TOWN OF SOUTH WINDSOR Permit No. " P 1• N�° PUBLIC WORKS DEPARTMENT TOVIfN HALL 1540 SUL'IIVAN AVENUE, SOUTH WINDSOR,CT_06074 , Name.of Firm P1' �ik Phone No, Jcfl Address of Firm )1"I UfX MfAP_,Z I A-� Location of proposed work Describe fully nature of permit requested Starting date 4/0�' Approx.time forcompietion U t" Call Before You Di No, o20), 9 Traffic Services_ConW No. Shove sketch of proposed work or furnish Tbis section to be tilled out by" w0w Of separate dravAO9Indicate North Town of South=Windsor Pavement Cut ' No cuts. Est,Size of Perm.Patdi(s) Est.PvL Th"ness in. Est.Unif`Pnce$ Mt:of Deposit4. Total Due$ by (` )Cash I Permanent Patch No. Cuts Size"of Patch(s) " Final"Billing ' $' i Amt.Due Payee " a Amt.Due Town BY Applicant is responsible for contacting Date the Police Dept and C.B.-Y.D.` t 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 WIT THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE 13Y THE RULES AND REGULAI IONS FOR PERMIT AS O IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT"UAL,., Signed: Y Date Title: Drivers License M PERMIT SHALL BE KEPT ON,JOBSITE AT ALL TIMES