HomeMy WebLinkAboutInstalling water main - Abbe, Garnet and 700133 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/20/07
GIS ID: 00609999 ::.
MUNIS APPLICATION# 200701332 / !F? FEE: 25.00
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' r"+"' EIRATION DATE: 08/19/08
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APPL
ICANT :.R::k•.. ':1
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LOCATI
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NAME. SI
MSCROFT ECHO FAI�IS'�..;� ':
ADDRESS: P O BOX 581 " y'-`
JVt�N OF .
SOUTH WINDSOR
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MSBURY CT 06070''
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APPLICANT AGREES TO FURNISH THE T'
QWN Ago'
,OP .OND�E� "., �,, ,,. QUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANT'EX�,FNS S;INC $ * T R6R; TENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THfi';AP ' H<q WILL: IDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN O :.S0.6 .PEI MY r,MANUAL.
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ISSUED BY DA`I E I .CE INSPECTED BY
8/20/20072:41PM *** PER IT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 900133 CONTRACTOR:
LOCATION:_ VV'\a 5 )(��Q
TYPE OF WORK:_ \,J - t YY1c�t t
DATE INSP NEEDED: DATE INSP: .Y (a?
INSPECTED BY: h
WORK IN
PROGRESS: M'r.skel r<A_
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AS-BUILT:
INPUT:
DATE:_
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm Address of Firm �, ,� �— Phone No.
X—
Location of propose work
J
De c-it f ly nature of permit requested
Starting date -,1 1
Approx.time for completion_ , :, r,^,a ;�✓
Call Before You Dig No.-2L2L . ��c��� �y ; Traffic Services Control No.
20u'1 s. ��� '
[�7-Ze—tch of proposed work or famish
es of separate drawing Indicate North This section to be filled out by
Town of South Windsor
Pavement Cut
No.cuts
0 Est.Size of Perm.Patch(s)
Est.Pvt.Thickness in.
Est.Unit Price$
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
the Police Dept.and C.B.Y.D.
AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES A TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
ND REGULATIONS FOR
PERMITS ASMD THE TO OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
_
Signed: _ r
Date:_ I? c
Title:
Driver's License
PERMIT SHALL B KEPT ON JOBSITE AT ALL TIMES