HomeMy WebLinkAboutStreet Cut Permits 92 Sycamore Road (2) 110044 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/09/11
GIS ID: 88800092 - --L-
FEE: 25.00
MUNIS APPLICATION# 201100413 y
AM
-� �IRATION DATE: 05/08/12
APPLIC LOCATION
NAME: M&S PAVING AND S A,-j-N ,�e r RE� A§YC MORE ROAD
ADDRESS: 435 BUCKLAND ROwis WS RICHARD&SHAWNA
SOUTH WINDSOR,C�Tb4 l =SYCAMORE ROAD
A AMR MM
TWINDSOR,CT 06074
PHONE 860-648-1915
WORK DESCRIPTION: DRINkY
APPLICANT AGREES TO FURNISH THE TW �JTIT A1VI4R(fl $ ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIPN ,IDAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE P' AI I IAR A W L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED INTHETOWNOF ?UTJIII?S FTP ITMANU AL.
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ISSUED BY DATE IN PECTED INSPECTED BY
5/9/201111:43AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: //bb09V CONTRACTOR: m+ S Pa l/ n g
LOCATION: a S
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: a
INSPECTED BY: 13.E
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [:] NO
AS-BUILT:
INPUT: DATE: o-'6`
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00 ��
Name of Firm r -+ S PC>q�, �, .� S phone No.
Address of Firm k\\ N �-� Lam" G i O co o S
Location of proposed work_G c-!.)- s p to S i ,
Describe fully nature of permit requested �rw112 • ICL &
Starting date I l Approx.time for completion
Call Before You Dig No—Q-C)% t t "l OC>`-t S. Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
0 Est.Size of Perm.Patch(s)
Est.Pvt.Thickness in.
�o
.Z Est Unit Price$
/ Amt.of Deposit$
'C Total Due$ by
( )Cash( )Check#
-Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
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 PE AND THAT I AM FAMILIAR WITH AND WILL,ABIDE BY THE RULES AND REGULATIONS FOR
PERMI AS OUTLINED IN TH OWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Tit1 . cZE Driver's License#:
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES