HomeMy WebLinkAboutWater Street Cut Permits 1010 Avery Stre M
Permit No . 2411
Date 04/03/! 998 Town or South Windsor, CT
Street Excavation Permit
Exp 1 r at i on Date 04/0,y/ i �4qq
Desc r i p ; CHASE ORCHARDS "i -
L_oc at, I On
Name GERBER GUNS,(ttliC i t Addr 1�i t v AVER ,31 RErT
, 616 DART HILL ROAf)
VERNON CT 06066
Phone (860 )875-668 Type raf�.. lark . WATER
Applicant agrees to f,u r,
ri s i�k . th,4 Tort o f' Sou � i nt s r the amount of bond
required and to reimburse ,the ""1"own ���
incurred by the Town for maes
r�tenarace darepa r wok .inconnectponany swth this
perm t and that appl ic:ant zs fam1l far' with 'and will abide by the rules and
regu i at i ons for permits . aarAl i ned in the Tc► ur! catoth Windsor 's Street
Cut Permit Manual .
PERMIT' Tv I1E KEPT Oj,,4 JC)B SITE;,A,7 ALL TIMES .
Issued by
i i-t.1 e �•, S
Date Completed
__-- _- Inspected By
APPLICATION OVFO OF SOUTH EXCAVATION PERMIT
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm "�S� � Phone No.
Address of Firm
Location of proposed work r
/r
Describe fully nature of permit requested oh"
Starting date 9 Approx.time for completion
Call before you dig no. 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
S
c'
-- No. cuts
�6 Amt. of Deposit S by
(1 Cash(1 Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
r
Amt. Due Payee S
J
o e Amt. Due Town S
Applicant is responsible for cont cling n
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 RFIMBURSE 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: Date:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES