HomeMy WebLinkAboutDrain Layers Permit Avery Street/Sewer M (2) Per,'mit No. 2235 ' Town of South Windsor, CT
bats 08/28/1996 Street Excavation Permit
Expiration -Date 08/28/1997 `
Descrip: MAIN TO NEW AVERY 'MEADOWS
Applicant Location
Name SIMSCROFT ECHO FARMS, ".-IllHITCHGOCK, TO,, PUMP STA.
Addr. P.O. BOX _581
SIMSBURY CT 06070 TYPE of Wo#�R BAN MAIN
Phone ( 860)651-0231
s
Applicant agrees to furA sh the ,.Tore-'Qf Sout ,-, Vindsor the amount of bond
required and to reimburee the i'own .of South Wi ' aior for any expenses
incurred by the Town fo'r ma n;tenance car= rOpai r work i n' connection with this
permit and that applicant ", familiar withi and °Wi1, 1 abide by the rules and
regulations for permits as ined' in the Towwn of South Windsor ' s Street
Cut Permit Manual .
*LEMIT SS KEPT -ON .10 , SITE, AT A'LL TIMES.
Issued by Title 1r
Date Compl`etjd � ' Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT 1
i
Permit No. 2235 Contractor SIMSCROFT ECHO FARMS
Location HITCHCOCK TO PUMP STA. Address P.O. BOX 581
Type Work SAN MAIN SIMSBURY CT 06070
Phone No. (860 )651-0231
3
1
Date Insp Needed Date�, Insp..
Time Insp Needed TIme Insp
Inspected By _
Work in Progress
Input Date
r.
APPLICATION FAR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
Amt. Bond Required PUBLIC WORKS DEPARTMENT
Amt. on File ce
3r�_ TOWN HALL Permit ' :� ^' 23
Date of Expiration 1540 SULLIVAN AVENUE Date — •-
Ins. on File (W les O No SOUTH WINDSOR, CT Permit Expires
Expiration Date FEE $25.00
Name of Firm s'^' Cr'o G f EC,(G �►�+rJ
Address of Firm • 04 V T.Q 0, I C" 7 C Phone Ca - G S 1 C 7-3 1
Location of proposed work 09V a M7- �•_"' 61 No. .r
.TD bpi psn"w_
Describe fully nature of permit requested 1^i3' �+ �� _- •� SC w+1. kin,41,y
Starting date 7 le' Approx. time for completion
Call before you dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
O Indicate North
Prop. size of out
�4. V P.U>b I ff bA_)pt� No. cuts
Amt. of Deposit $.. by
�) Cash O Check #—
t Cut size after Perm Patch
No. Cuts
Final Billing $
)
Amt. Due Payee $ —.
Amt. Due Town $
Applicant is responsible for contacting
the Police Dept. and C.B..Y.D. by date
I agree to'funish 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 tthee rules and regulations for permits as outlined in the Town of South Windsor's Street Cut Permit Manual
Signed: 1:5"b t1` Title: {/p- (jLy
D.L.L.# Date: tS/ 7,1
PERMIT BE ON AT ALL TWES
APPROVED: _DATE:_
TO NGINEER
FOR INSPECTOR: Date work started Pate Completed
Signed Date
WHITE - PERMIT PINK - ST. SERVICES
YELLOW - ENGINEERING "' '' GOLDENROD - FINANCE
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