HomeMy WebLinkAboutDrainage installation Street Cut Permit Permit No. 2337 Town of South Windsor, CT
Date -08/07/1997 Street Excavation Permit
Expiration Date 08/07/1998
Descrip: SMALL MISC. DR. 97-101 ANN/ ALLISON
Applicant ,Location
Name COUNTRY STONESCAPES 005,0 ALISON DRIVE
Addr. P.O. BOX 95
MARLBOROUGH CT 06447 Typ.s .gf Work STORM
Phone ( 860)228-2774
Applicant agrees to f ur,n ah t he Town ,`ofl SOFA - Windsor the amount of bond
required and to reimbur. e ,thy Town own- out V�'1r�dr '.,for any expenses
incurred by the Town for maintenance On,..i-epai'r 4vArk .in' connection with this
permit and that app l i cant i.s�,�-fami 1 tar With and'.,wf,"l 1 . a;b'i de by the rules and
regulations for permits-gas out 11hed �An. Tow -opth Windsor' s Street
Cut Permit Manual .
* * PERMIT TO BE .kEPTI,ON -JOB--1STTE AT ALL TIMES.
Issued by y ~.- Title �
Date Completed Inspected By
z33 7
y APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm caaalrwC izog= z Z Phone No.
Address of Firm
Location of proposed work
Describe fully natur ermit requested
Starting date Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut /Y
No.cuts
Amt.of Deposit$ by
Cash O Check fi
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee$
Amt. Due Town$
Applicant is responsible for contacting
the Police Dept.and C.S.Y.D. by date
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.
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Sig Date: p ✓
Title: D.L.#t
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES