HomeMy WebLinkAboutWater Street Cut Permits 788 Avery Stree Permit .No... 2666
Date Iowa of South Windsor. CT
04127/ 1999 Street _ Excavation Permit
Expiration Date 04/26/2000
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Applicant
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Adde. 25NNORTHCROADWATER C �N f' � VE1STREE
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EAST WINDSOR CT 0648b
Phone (860)292-5552 yvf CATER
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Applicant agrees t ur ,sh the't <
required and to reimbur �' rL+�dor the amount of bond
' o t f vqt_Ath Wi fir; ��r any expenses
incurred by the Town ,for a�rM
enapai rvo€ i connection with this
permit and that app l rant f 11�i 3 r 4an '101-41 jt,' a.b i de by the rules and
regulations for permi s ;aq; Mjt 1 1 d n the T W f 5asuth Windsor ' s Street
Cut Permit Manual .
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* * PERMIT TO ,B ' KEPTU ST"fi AST .ALL TIMES .
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2666 Contractor CONNECTICUT WATER COMPANY
Location 0788 AVERY STREET Address 25 NORTH ROAD
Type Work WATER EAST WINDSOR CT 06088
Phone, No. (860)292-5552
Date Insp Needed Date, tInsp o1-90)
Time Insp Needed Time I,hop
.l. 2
Inspected By
Work in Progress wcg a �.�Gk. 1, A tAwej AffA -To 9C
Input Date �7/d0l15
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 f 0n (7 U (� ' Phone No. �q 9- 5
Address of FirmI5 )�ba-Hq'cd..
Location of proposed work -
Describe fully nature of permit requested
Starting date - Approx.time for completion 1 .]
Call before you dig no. I Cj G G I ��F?,`'`�I I r�i Traffic Services Control No.
Show sketch of proposed work or furnish r To be filled out by Town of So Windsor
two copies of separate drawing N — Pavement Cut
Indicate North Prop.size of cut
No.cuts
D Amt.of Deposit $ by
N O Cash O Check M
Cut size after Perm. Patch
No.Cuts
Final Billing S
ot 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: V 1�l[ lX i/11I 1l_l l��1 Date: Al-,J q
Title: (JIIG�� � l 9 D.L.B
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES