HomeMy WebLinkAboutStreet Cut Permits 88 Edgewood Drive (2) 1200079 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 05/22/12 =
GIS ID:29400088 FEE: 00
MUNIS APPLICATION# 201200639 - EXPIRATION DATE:
APPLICANT LOCATION
NAME: METROPOLITAN DISTRICT ADDRESS,_' g EISGEWOOD DRIVE
ADDRESS: 125 MAXIM ROAD ' ERA VLINTZ MARK A&KAREN P
HARTFORD,CT 061 uI', — 8�;EI�GWOOD DRIVE
lbww Jr-
PHONE
S�UTFL WINDSOR, CT 06074
-------------
WORK DESCRIPTION: NEW WWERN NE N,
APPLICANT AGREES TO FURNISH THE TF)WItiI QF SOUTH INI -l- TF1E AMOUI IT OF BGN- REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EfPENSEINCfIIBYIIE T}yJV pORDr1?,INTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI IPPLTCANT IS FAIvIII IAA WITH A-N-b-WIC L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOU-TH WIN"DSR'S TREE`EUT PERMIT MANUAL.
If
ISSUED BY DATE INSPECTED INSPECTED BY
5/24/2012 11:31 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
iy
st
�"
TOWN OF SOUTH WTMDSOR IMSPECITON-REPORT
LOCATION:—? �G� cdc7�
.'TYPE OF WORK• 1;12at`i'� G��►�i�e ,�tom.
:DATE INSP NEEDED:____ DATE INSP: J
6Y:
-WORK IN
PROGRESS:
SEPTIC TANK PUMPED,SMASHED,FILLED Wn NFSSED (]YES Q NO
-------------
AS-BUILT:
INPUT: 0 DATE:
W/2007 Town of South Windsor INPSECUON REPORT 07
THE METROPOLITAN DISTRICT - PAVEMENT CUT DATE: S'=�>��2-
BILLJOB YES❑ NO P" WO#
ti
ADDRESS TOWN S� Z✓c v� —STATE HIGHWAY YES Q NO 9--
DRAW SKETCH SHOiVING LOCATION AND SIZE OF CUTS AND CUT MADE IN
CROSS SECTION OF PAVEMENT
STREET BIT. CONC. 0 CONCRETE ❑` PREMIX ❑
SIDEWALIt BIT, GONG. ❑ CONCRETE ❑ FLAG ❑
CURB • BIT. CO NC. ❑ CONCRETE ❑ STONE ❑
DRIVEWAY—BIT CONC. ElCONCRETE ❑
GRASS ✓ LOAM&SEED NEEDED YES❑ NO L -' �
REASON FOR CUT:
�
�,.
,vim `-- �'
,ram NUMBER OF CUTS: r p
DATE OF FIRST CUT: ���`
IS.SOB COMPLETED: YES f�O❑
FOREMAN: /./ �`'�f
k
REPLACEMENT PAVEMENT CONTRACT NO.:
BIT. CONC. D CONCRETE ❑ PREMIX ❑
DATE COMPLETED:
ACCOUNT NUMBER:
CALCULATIONS
E z
OF CU7 ITEM# M ITEMS! ITEMS �
. a
PRESS HARD, 3 COPIES (ORIGINAL)' OPERATIONS NS UTIL(WHITE,rVICES CONTRACTOR( L