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HomeMy WebLinkAboutExcavate and repair main break Street Cu Permit No. 3885 11/15/2 d 004 Date Town of South Windsor, CT Street Excavation Permit Expiration Date 11/15/2005 Descrip: AREA NEAR 20 ARODA-EM RG$LI. 3:_fy}A MA111K A BREAK Applicant h .- Name CONNECTICUT WATER -00MV-A— A.Addr. 25 NORTH ROAD l r yR©DA pRTVE EAST WINDSOR CT 06088 l ' Phone (860)292-5552 9�A# ,W s a:.<,.,: :;.::;r,., TAR orlg r %- Applicant agrees., tC? required and to furz3s�s3i :the �wFo ` It h Windsor the am'OUnt of bond reimburse tiepwn'of Sough141sor fr :ri' expenses incurred by the Town fox m :ritnniS, @3i } ork lid Cttixecioi with this permit and that applicants >fzmilx t6ii £ € l gy regulations for permts: ,�s otlie h T � b..r the rules and Cut Permit Manual. ` © 64V WiEd9ot s Street * * PERMIT tO 73E ERI' CEN. J ::+1 F' Issued by ' » —"`Y------------ Date Completed B : y TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3$g5 Corlx'ctor CONNEChJT WATER COMPANY Location ap <AXa4r.e(zk <z 3`25 N R7E ROADr.: Type Work WATER z. IffD8jR <:CT�088 %" Pioneo �8 295�x5 Date Insp Needed ` ------------ --- D a t� IfJ — : c :s>Time Insp Needed *'y;:::;xa ,• :s ,3: V. Inspected By R.Worf V s k in Progress KX ;: .xR .r'''. ---------------------- 'v.. t.. n I p rf< u a t e NOV. 15, 2004 11 :4A CONNECTICUT WATER Commsor Town Hall N0, 275 P. 1 Q002/002 APPLICATION FOR STREET EXcAVATtON PER11VIt'GOWN OF SOUTH WINDSOR � PUBLIC WORKS DEPARTM'EWT Pe it No. TOWN HALL 1840 SULI,.I'VAN AVENUE • SOUTH WINDSOR,CT 06074 Name of Firm Connc�-i FEE$25.00 Address of Find S Phone No 2 3- 3 • /l.o � � � � rvi n X 3S� Nation of proposed wor a� Dr Describe fully nature of permit Mquoste �c_-:'x Call Before you Dig No��oo yy� Approx time for comp(etic d Traffic Services Control No Show skelboh NO eon of�separalcarfuml5h te Incrmam North, ,on to 0 T n of Wl ds r Pavement Cut No.cuts ' Est.�Ske of Perm.Pates) Est Pvt.Thin L- Est.,Unit Price$ Amt of Deposit$ Total Due by A2op(J p2 . ( )Cash( ')Check Permangnt patch No. Cuts_ - - Size of Patch(s) Nye' Final Biving Amt Due Payee Amt.Due Town Applicant is responsible for eoMdetntg By tFre Pdice De t and C.B.Y.D. Date f AGILE TO FURNISH TO Tyt:TOWN OF SOUTH WINp50R 7"NE AMOUNT OF BOND TOWN'OF, N wn- THISWIND OR FOR ANY EXPENSES INCURRED By THE TOWN FOR fNAlNTENANC CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE R NWNUIRED AND R REPAIR W PERMITS AS O[ITI.IN IN THE TOWN OF SOUTH WINDSOR'S WITH AN CUT PERMIT y TH E OR REPAIR WO IN Tt1l=RULES AND REGULATIONS OR Sigr�scl: v �''�' AL. rare- Datm 11 ' S Driver's License g., PE Mrr S"A L ES KEPT ON JossrrE AT AIL-nMEs