HomeMy WebLinkAboutRepair broken water main Street Cut Perm (3) TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2527
Location 0009 ARNOLD WAY Contractor CONNECTICUT WATER COMPANY
Type Work WATER Address 25 NORTH ROAD
EAST WINDSOR CT 06088
Phone No. (860)292-5552
Date Insp Needed
Da e' Insp.
Time Insp Needed
" . Ti ate ►'i$P•
Inspected By , �
Work in Progress � �
Input Date
Permit No. 2527 Town of South Windsor, CT
Date 02/01/1999 Street Excavation Permit
Expiration Date 02/01/2000
Descrip: REPAIR MAIN
Applicant � :. Location
Name CONNECTICUT WATER COMP 1Y ' > .
� ( Q9,,-ARfiJQ -IWAY
Addr. 25 NORTH ROAD i , '` ' - ;z
EAST WINDSOR CT 06t88 Ty,p,�'a WOi l ATER
Phone (860 )292-5552 w
Applicant agrees t r,n,7,' h -the ,Td i `f Sit k i i dor the amount of bond
required and to re i mbur s� tM�\ Town cif _0; Wi d or #nor any expenses
incurred by the Town #or � enanc }r� � pairnki ilk connection with this
permit and that app l i cai f ait� tr wh anc# ay fi ate i de by the rules and
regulations for permit , stlined in the own of Soth Windsor's Street
Cut Permit. Manual . a
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* ! ,KE � a ®f
PT
PERMIT BL ,;8`1-i AT ALL TIMES.
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Issued by
Ti e
Date Comp et d _ � � Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm Phone No
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date Q Q Approx. time for completion
Call before you dig no. I Pin 7 Traffic Services Control No. --
Show sketch of proposed work or furnish To be filled Out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
N Q�
` Amt.of Deposit$ by
cz I � ()Cash()Check#
Cut size after Perm. Patch
No.Cuts
Ci ea-i K�
Final Billing S
Amt. Due Payee $
Amt. Due Town $
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 1 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:
'`-!��! ��r � Date:_ /f/ `7
Title: ( /�t1e �' �/ /�1l D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES