HomeMy WebLinkAboutRepair broken water service in cul-de-sa Permit No. 2460 Town of South Windsor, CT
Date 07/08/1998 Street Excavation Permit
Expiration Date .07/08/1999
Descrip: REPAIR BROKEN WATER SERVICE
Applicant r'^
f " Location
Name CONNECTICUT WATER CO( Y
` PL,EINTREE LANE
Addr. 25 NORTH ROAD (,
EAST WINDSOR CT 06Q $ Ny y, ATER
Phone (860)292-5552 ',, µ
Applicant agrees to ' he a i or the amount of bond
required and to reimbr ',"-;.; h any expenses
incurred by the Town for-, n nc pal i connection with this
permit and. that appli nd l ide by the rules and
regulations for permto- 1 , th Windsor's Street
Cut Permit Manual . �F, O4411
* ERMIT TO L TIMES.
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Issued by
Date Compl to _ Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
PUBLIC WORKS DEPARTMENT
TOWN HALL C)
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm L^ ter (20
Phone No.
Address of Firm fl
Location of proposed work wle,
Describe fully nature of permit requested +
Starting date
Approx.time for completion
Call before you dig no. 1 Traffic Services Control No. —�
Show sketch of proposed work or furnish TO be filled OUt by Town Of SO W1ndso
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
�A
No.cuts
Amt.of Deposit$ by
O Cash Check
() eck#
Cut size after Perm. Patch
No.Cuts
(( to
F n Final Billing$
Amt.Due Payee $
$
Applicant is responsible for contacting Amt.Due Town
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: (J � � � Date: (9
Title /C(( �(1/(/,d/ D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES