HomeMy WebLinkAboutStreet Cut Permits 129 Foster Road (3) 1300085 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 05/09/2013
GIS ID: 33300129 v FEE: 0.00
MUNIS APPLICATION# 201300579 jr
&PIRATION DATE:
AIN
j�
APPLICANT = p LOCATION
NAME: METROPOLITAN DISC RIFTr DRES� f2o- OSZ'ER ROAD
ADDRESS: 125 MAXIM ROAD
E "; 1'U�c R GORDON G
HARTFORD,CT 061 Wj
129 Ii jER RD
i� T-1 INDSOR,CT 06074
PHONE
i >
WORK DESCRIPTION: BOX33AND R(�VC�# Soff
APPLICANT AGREES TO FURNISH THE T1)Wj-OF Q $ 1D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EEN�ESt�t�IV�{IR1pINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THI; 'I fCAT IS I'A ,� A W ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 0 W1I�s�'#��T��CI�T PETIT MANUAL.
/
ISSUED BY DATMPMIIPPJCTED INSPECTED BY
5/9/2013 8:59 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
i
Ad - ,
a— i
—
//
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 3O_$ CONTRACTOR:
LOCATION: 1 a
TYPE OF WORK:
DATE INSP NEEDED:_ DATE INSP: 11 v5
PO ECTED BY. Ay
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED,FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L DATE:_ I
S/FORMS(TOWN OF SOUTH WINDSOR INSPECTION
MD-039,Rev 2/12 THE METROPOLITAN DISTRICT - PAVEMENT CUT DATE:
ADDRESS otr_L5.�/' oe-.41- BILL JOB 0 YES u-<6 WO#_ .!ca:z
CLOSEST STREET TOWN I-!:—;, -STATE HIGHWAY 0 YES 94<
DRAW SKETCH SHOWING LOCATION AND SIZE OF CUTS AND CUT MADE IN
CROSS SECTION OF PAVEMENT 0 STREET OBITUM. " 0 CONC. . 0 PREMIX
-1 13SIDEWALK D BITUM. " 0 CONC. " 0 FLAG
OCURB OBITUM. 0 CONC._ 0 STONE
0 DRIVEWAY OBITUM. 0 CONC,
dRASS LOAM&SEED NEEDED 0 YES 2146'-
REASON FOR CUT: 1_�6
DEPTH OF EXCAVATION:
NUMBER OF CUTS:
DATE OF FIRST CUT'
IS JOB COMPLETED: 0-1-E-Si ONO
FOREMAN:
REPLACEMENT PAVEMENT CONTRACT NO,
BITUMINOUS 0 CONCRETE D PREMIX 0
DATE COMPLETED'
ACCOUNT NUMBER:
CALCULATIONS ,
N—O
OF QT ITEM# ITEM ITFEMA ITEM
ommmrz itjqpr-r,,rnrt CONTRACTOR