HomeMy WebLinkAboutStreet Cut Permits 129 Foster Road (2) 1200168 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 09/11/12
GIS ID: 33300129 FEE: 00
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APPLICANT LOCATION
NAME: METROPOLITAN DISTRICT " ADDRESS: 129 FOSTER ROAD
ADDRESS: 125 MAXIM ROAD C� �R SAUCIER GORDON G
HARTFORD,CT 06114 "= 124 FbSTER RD
SOUTH VVINDSOR,CT 06074
PHONE = "
WORK DESCRIPTION: SERV G, 13OXI EPAIR ;"
APPLICANT AGREES TO FURNISH THE TQW I OFSOUTH WIND R`I WAMOU I Cl BC}ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY.EXPENSES I—Nt BY T ICE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FA"MIAR WIT ARID WILT ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SCjI3T- W I II�SR3 =aTREE T CIT PEL I fIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
9/11/2012 10:49 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ,3 6a l& Q, CONTRACTOR: VVA k>,C
LOCATION: �t7S
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 3
WORK IN
PROGRESS:_
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: Cam-- DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
MD=039, Rev 2112 J THE METROPOLITAN DISTRICT - PAVEMENT CUT DATE:
DRESS {� e' BILL JOB ❑ YES ❑AO WO# .'5
OSEST STREET _Gt r�� C' OC�: TOWN,—lwt 10 L SCS•,- STATE HIGHWAY ❑ YES 940'
I
I RAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND CUT MADE IN
CROSS SECTION OF PAVEMENT w'
� ❑STREET OBITUM. ❑ CONC. ❑ PREMIX
C5 ❑SIDEWALK 0BITUM• " ❑ GONG. ❑ FLAG
0 CURB ❑BITUM. ❑CONC. ❑ STONE
[]DRIVEWAY ❑BITUM, " ❑ CONC.
[G "
RASS LOAM & SEED NEEDED AYES P
REASON FOR CUT: SP1'IJ l 4 ' O 3C r livev Z
•J
:0
DEPTH OF EXCAVATION: o
NUMBER OF CUTS: !z
DATE OF FIRST CUT
IS JOB COMPLETED: YES []NO
FOREMAN: 4F-6�f 4 (Lc 2
Flf
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C/D
3,� REPLACEMENT PAVEMENT CONTRACT NO-
KN
C/D BITUMINOUS 0 CONCRETE El PREMIX ❑
DATE COMPLETED:
ACCOUNT NUMBER'
CALCULATIONS ;
Q J N
OF CUT ITEM# ITEM# ITEM# ITEM#
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PAVING INSPECTOR CONTRACTOR
PRESS HAND, 3 COPIES (GRIGINAL) (YELLOW) �;