Loading...
HomeMy WebLinkAboutReplace broken water service Street Cut (2) i Permit No. 2665 - � own of South Windsor, CT Date 04/27/ 1999 Street Excavation Permit Expiration Date 04/26/2000 Descrip : Applicant Location Name CONNECTICUT WATER COMFj41`!Y OA, S' A PPI JREE LANE Addr. 25 NORTH ROAD . - 8 , EAST W-INDSOR CT 0608� _ R qf, ii c' WATER Phone ( 860 )292-5552 r Applicant agrees t f Urn �outW-W nd�or the amount of bond required and to reimburse h fio1 of t�tth iMttAibrpr any expenses incurred by the Town ,=for444iiettenanee o pair, k in connection with this permit and that app l ,and 41 1 `a,�i de by the rules and regulations for permi in -fh'o �TQ,Whl-ref. gauth Windsor ' s Street Cut Permit Manual . _ * * PERMIT TO B KE1�T �! JCil IT E ,4`T ALL TIMES. 4 t Issued by 1.7 Date -Completed _4 0© Inspected B TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 2665 Contractor CONNECTICUT WATER COMPANY Location 0029 APPLE TREE LANE Address 25 NORTH ROAD Type Work WATER EAST WINDSOR CT 06088 Phone, No. (860)292-5552 Date Insp Needed p Date Ins Time Insp Needed Time Tnsp 2:5� Inspected By Work in Progress 4vo* s r- IEM f - Ii2StAll3A lwisAL l.�wn1 demos T� iSF- _p Input Date -5-1 i5 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 i a` L� - '1 Phone No._ `� f7� Address of Firm Location of proposed work d- Describe fully nature of permit requested > �L 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 CUL Indicate North Prop.size of cut No. cuts Amt. of Deposit $ by Q� () Cash()Check# Cut size after Perm. Patch No.Cuts . Final Billing S Amt. Due Payee $ �) Amt. Due Town S Applicant is responsible for contacting the Police Dept. and C.B.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. Signed: �( Date:_ Title: /rYJ - - D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES