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HomeMy WebLinkAboutMiscellaneous Street Cut Permits 702 Ave Permit No. 3539 Date 06/27/2003 Town of South Windsor, CT °"° Street Excavation Permit Expiration Date 06/26/2004 Descrip: INSTALL YARD DRAIN Applicant Location Name CIVIL SOLUTIONS LLC 0702 AVERY STREET Addr. 115 GOTTER RD TOLLAND CT 06084 Type of or MISCELLAN Phone (860)896-0222 Applicant agrees to':,fuxn;sYk the..Tawn s�f d1yt: Windsor the amount of bond required and to reimburse the Town zf u�q]t:�h Windsor f`or ariy= expenses incurred by the Town for m& T�°tenance or repair work i.n conuscto with this permit and that applicantion is :familiar wxt' and will abide:by t' rules and regulations for permits as outlined.in the. Town of South Wind"sor-s Street Cut Permit Manual. * * PERMIT TO $E' TfEPT ON JG SITE AT. ALL, TIMES. 11 Issued by C 1 1 ��' ---------------- --- _ Title 4 Date Completed ----------------- Inspected By r TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3539 Contract tlr CIVIL' SOLUTIONS LLC Location 0702 AVERY STREET Addre s 115 DOTTER ''RD Type Work MISCELLAN TOL.LAND CT o60$4 Phone No {S6p.:j.896=o.a22 Date Insp Needed -------------- Time Insp Needed ------------- Time Tnsp Inspected By ` Work in Progress �3Y a In put __ �� Date !_f�- +-�1 35'3 �3 • APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT 4 TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSORf CT FEE $25.00 Name of Firm C i 0 L �: i�c��� ) L IL Address of Firm i r�,� 1 Phone No._ ���� "8`�►�n-� Z� o �'T Location of proposed work �70�. V�Q Describe fully at re�o��rmit requested__.LvsmLL L aQ© �rc�iv Starting date - Approx,time for completion / W Call Before You Dig No. c �.s�v 6 Traffic Services control No. A r� Show sketch of proposed work or furnish two copies of separate drawing SEE SXZTe N To be filled out by Town of South Windsor o u FILLS W i7 4 Pavemeft Cut Indicate North �ti,,N �f�, � Prop.size of cut No.cats Amt.of Deposit$ by ()Cash()Check# I ?� Cut size after Perm. Patch No. Cuts if rao5 Final Billing$ ca Avg 5T Amt.Due Payee$ Amt.Due Town$ Applicant is responsible for contacting by the Police De and C.B.Y.D. date I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND To REIMBURSE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTIONEWITH 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 WINDSORIS STREET CUT PERMIT MANUAL Signed: Date:— �/77/03 Title: D w PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES Standard Fonns\Permits\Street Excavation Permit.doc