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HomeMy WebLinkAboutStreet Cut Permits 200 Deming Street (8) 1400104 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 05/06/2014 5 t _ GIS ID:27600200 xu FEE: 25.00. MUNIS APPLICATION# 201400517 Y4W' - K�' XPIRATION DATE: 05/06/2015 APPLICAI 'f�� €r LOCATION NAME: CONGRESS BUILD G COMPSs Y �3 � �DDRL? S ; �dU D=MING STREET ADDRESS: 2 BOURBON STRE 4`� s � �� 9UN$t �s IP I CB SOUTH WINDSOR LLC PEABODY,MA O 1i6� `� i a s �; 7:' aEGWATER DR STE 101 '' t IORWOD,MA 02062 PHONE 1-978-535-6700 l 4 -S Est WORK DESCRIPTION: IN A49 L IVgmNkW z E AIsI S�� 1 Cz TAN BUCKLAND RD mAl APPLICANT AGREES TO FURNISH TH Oi� 0i �D AIV1V I� OND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR I KY ,3"II AINTENANCE OR REPAIR WORK 1N CONNECTION WITH THIS PERMIT AND Tf iO�41C�II�T I�3"'T ?' V4jI I I 4cry D L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TO WN (U T3 SR'�5; iRI; T11T PE3MMIT MANUAL. 5 ..� t { ISSUED BY DAT SPECTED INSPECTED BY 5/6/20 14 1 1:42AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** r_ Af Vgg V. jit lv�t rF E TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 11-16OLoL CONTRACTOR: �c��� S 9G LOCATION:- -- 6700 ) C-?lnioq .SI-l-eer TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: C VV*"- DATE: S/2014 Town of South Windsor INPSECTION REPORT 14 APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 !Name of Firm .o^ C, Phone No Atjdl ess of Firm W P Location of proposed work 2 0 0 Da x Aj n bus Describe fully nature of permit requested ju s Starting date Approx. time for completion a L1 e�k 5 CalhBefore You Dig No. Traffic Services Control No. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor ::._:,.:_.-...:_.:..;.. . . .. Pavement Cut : . No. cuts Est.Size of Perm. Patch(s) Est. Pvt.Thickness in. Est. Unit Price$ Amt.of Deposit$ 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 Palice`De t.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 PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR .'::.PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Stgned ..� r/'. n Date: 3 A.��y Title: SLpp�-f ,e/fe,y [���el Driver's License#://c�,�S g©r� a PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES