HomeMy WebLinkAboutStreet Cut Permits 50 Glenwood Road (2) 1100160 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER ,
STREET CUT PERMIT
DATE: 10/11/11
GIS ID: 35700050
MUNIS APPLICATION# 20110.1184 FEE: 25.00
E 10/10/12
APPLICANT Yy - LOCATION
NAME: M&S PAVING AND SEALING,TNC
ADDRESS: 111 COMMERCE WAS' ; ADDRESS 5 GLE ;WOOD ROAD
OW1 ER I�ATTA I EBAPRIYA
SOUTH WINDSOR,CT 904 ;
50GLEIWOOD ROAD
PHONE 860-648-1915 --- DU INDSOR,CT 06074
WORK DESCRIPTION: DRIVEWAY
APPLICANT AGREES TO FURNISH THE TOW01 SOUTH V�II3pR CIAll AND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC'6 ENSES IN �TRRED,BY,' T(� JR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THAPpLGANT IS F1�MIIdAR WJTH ANID WIL76
L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S�UTII WIN,DSR-' STR--CUT p- ---Ej MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
10/I1/20119:58AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: - /00/&0 CONTRACTOR:
LOCATION: (
.'TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:- 4e n
-- - - -- WORK TN - - - --- - - - ---- - -- - -- -- - - --
PROGRESS: -L Gh
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
'AS-BUILT:
INPUT: �___
DATE:_ � Jam_
W12007 Town of South Windsor INPSECTION REPORT 07
APPLICAT10N FOR STREET EXCAVATION PERMIT
TOWN OF-SOUTH INDSOR Permit No.
PUBLIC WORKS p.EPART{tiIIENT
TOWN FALL
1540$ULLiVAR.-A"/ENUE
SOUTH W1(�DScOR,C OS074'
Name of Firm M t s Phone No. 8( S
Address of Firm l _
Location of proposed work 2_�D ,
Describe fully nature of permit requested
Starting date �113 t t Approx,time far completion_- v -.S
Call Before You Dig No._a ai `tdoo S 9 3 TraffioServices Control""No.
Show sketch of proposed work or furnish TFtis se ono:be filled out'bu
two copies of separato drawing Indicate North Town"of Sough N/lndsor 1
Pavement cut
0 No.cuts'
Est.Size of Perm.Patch(s)
i
Est.Pvt Thickness in.
Est.Unit Price$
Afrit.of Deposit
Total Due$ by
Permanent Patch
No. Cuts
Size of Patch(s)
inakBilling
Amt.Due Payee
Amt.Due Town
ay
Applicant is responsible for contacting Bate
the Police Dept.and C.B.Y.0
I AGREE TO FURNISH TO THE TOWN OF SOUTH WI"NDSOR THE AMOUNT 01=ION :R!*QUIRED.AND TO REIMBURSE THETOWN OF SOUTH tNINDSOR FOR ANY EXPENSES 1[VC"UR 9!0 0' THE TOWN,l�R I�;INTBNANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERNIlT AND THAT"1 AM FAMfL1A t WiTFf"4,0" 'ILL AgiQE 'Y THE MULES AND REO.t)t.;WTlONS FOR
PFRMITS AS OUTLINED"IN THE TOWN OF SOUTH WINbSOR'S STREEP GU7 PERMITMANIJAL.
Signed:
date:
Title: O.6%I C7 e» v'r(en— Driver's License#
PERMIT SHALL BE KEPT ON'JOBSITE AT ALL TIMES
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