HomeMy WebLinkAboutDriveway Street Cut Permit 28 Oakwood Dr 1000068 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/30/10
GIS ID: 66000028 FEE: 25.00
MUNIS APPLICATION# 201000489 TION DATE: 04/30/11
APPLICAN
OCATION
NAME: M&S PAVING ANDS OD DRIVE
ADDRESS: 435 BUCKLAND RO ER C RICHARD J&PRUDENCE H
SOUTH WINDSOR,C 7 = OD DRIVE
DSOR,CT 06074
PHONE 860-648-1915voe
WORK DESCRIPTION: REMO
APPLICANT AGREES TO FURNISH THE TO OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E F MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APP T ) LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUT T T ERMIT MANUAL.
1 - -T zs-/l (
ISSUED BY DATE INSPECTED INSPECTED BY
4/30/20101:17PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION: a) OGT'
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: I
WORK IN
PROGRESS: 'b ei e Lgok 8
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:_
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT food
TOWN'OF SOUTH WINDSOR Permit No
PUBLIC`WORKS DEPARTMENT'
TOWN,HALL "
154Q`SULLIVAN,AVENUE
SOUTH WINDSOR;,DT 06074
FEE;$25.00.
Name of Firm l!� Phone No. 5
Address of 7 AJ
600
Location of proposed work ( "'
Describe fully nature of permit requested = (�
Starting date 0 Approx.time forcompietion 1k) r .
Cali Before You Dig No, -J()1!� 11 Traffic Services Control No.
Show sketch of proposed work or fumish This'section to be filled out by
two copies of separate drawing Indicate North Town'of South wndi6u .
Pavement Cut
No.,cuts`
Est.Size of penis.Patch(s)
Est.P4,Thiduie` -
Est:Unit Pnce$'
~Amt.of Deposrt S- F
Total Due:p by `
( )Cash(✓)Check# 3 b2
Permanent Patch
No. Cuts
Size of Patch(s)``
Final Billing
a
Amt.Due Payee
a
f Amt.We Town
, , .
ill ,'tC 1t1 ti' :iC� BY
Applicant Is responsible for.contacttng Date
the Police De t and CB.Y.D. E-,
-f
1 AGREE TO FURNISH TO THE TOWN OF SOUTH WIND$OR THE AMOUNT O BOND REQ�IIRED AND TO REIMBURSE THE
TOWN OF",SOUTH WINDSOR FORANY EXPENSES INCURRED`BY::THE,TOWN FOR.MAINTENANCE OR`REPAIR VNORtC IN
CONNECTION'NITH THIS PERMIT AND THAT I AM FAMILIAR WITH AN6WILL ABIDE BY THE RULES AND.REGULATIONS FOR "."PERMITS AS OUTLIN DIN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:' Date:
Title: p• Driver's License#:
PERMIT SH L BE KEPT ON.JOBSITE AT ALL' TIMES