HomeMy WebLinkAboutStreet Cut Permits 84 Gorski Drive 1100177 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 11/14/11
GIS ID: 36600084 - FEE: 25.00
MUNIS APPLICATION# 201101336 EXPIRATION DATE: 11/13/12
APPLICANT , LOCATION
NAME: TELE-NETWORKS ADDRESS: 84 GaRKI DRIVE
ADDRESS: 31 BAKEWELL COURT = {1WS�TER: MARREItO MARIANO JR&EVELYN R
CRASTON,RI 02921 84ORI DRIVE
SOJH WINDSOR,CT 06074
PHONE 401-461-8420
WORK DESCRIPTION: REPLAOING CAI V
APPLICANT AGREES TO FURNISH THE 1€)WP DF SOUTH=W�DSOR-FIE A *FI'MOI 0FU30ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANijE& NSES INCURT�ED I3Y TIDE TOWN 1-FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE'APPLI6wIS FAII�ILIAR WITH ANI3 WII L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF��)UTH WINDSR'S S REST CUT;PERIVIIT MANUAL.
ISSUED BY DATE"INSITCTED INSPECTED BY
11/14/201112:26PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO..--II OCR (_7 7 CONTRACTOR: J—t_ F'-
LOCATION:_
.TYPE OF WORK:_ ICV-
DATE INSP NEEDED: DATE INSP: � �t
INSPECTED BY:_ E
WORK IN
PROGRESS: 'Do 01� S K-4-
C
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
'AS-BUILT:
INPUT: DATE: ! d3
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR PFRMI
CALL 1-800-922-4455
Permit Number TOLL FREE-BEFORE YOU DIG C.B.Y.D.#a$���2j�
To Be Filled In By Municipality
INFORMATION TO BE FILLED IN BY APPLICANT
TYPE OF PERMIT: Walk Curb F I Street Excavation
PP L— Driveway
Drain Layi Grass F-1 Other
A lic ant's Name — 4 - " (� c Explain Other
Address 1 v� Contractors Name
p OVI C 0 Z_ Address
Tel.No. During Hrs. S(a0 "'12- C4Ci5L1
Tel. No. Aft Hrs. (Emer ency) cat• (o4j• �� —Tel.No. During Hrs.
Location of Work q -,qo GOC c-C: YJ12- Tel. No. After Hrs. (Emergency)
Starting Date I d ?7 s A-1 I _Approximate Date of Completion eo-
Show Sketch ���. A4CNCV
SAjfed Date See Conditions On Back
Applicant
certify that I h ve read &understand the conditions stated on the back of this permit and agree to all of those conditions.
INFORMATION TO BE FILLED BY MUNICIPALITY
Is The Contractor Licensed? Yes No Special Conditions
Is Bond on File? Yes No
Is Certificate of Insurance on File? Yes No
Is Permit Fee Required? $ Yes No
Permit Issued - date
Permit Expires
INSPECTION INFORMATION
Date Work Began
Date Work Inspected
Date Completed
Name of Inspector
Type of Repair Permanent
Type of Repair Temporary
Date of Permanent Repair
Name of Patching Co.
PERMIT APPROVED BY: DATE
a w31 (3
1 !,
61
i 1 ` RGb
1 R2
so RG 80
- 1
A;
i
72 50 ; 64 50 /�''/
RG6 R2 RG6/'
84
1 $
1
CROF1 �N) gAN -
1
i CL-
'n e3
�; 5ppP3
1
93
1 1 �
1
1 1 R2
R , 99
6
/ b
i
1
i
\A P` E
v
2W:
90 b `
� t