HomeMy WebLinkAboutWater Street Cut Permits Avery Street at Pe r rn yt Afc7; 7
Date 2478
- f .07/31r1998
Town of EXpiration Date p7 South Windsor,
/31/1999 Street Excavation Permit
Descrlp= WATER MAIN INTO CHASE ORCHAR
D SUBDIVISION
Applicant
Nadi. STATE LINE SEWER Location
238 SHAKER ROAD & CONST CO
ENFIELD AV1=R'� ST AT TALCOTT
Phone (860 LT 06082 RIDGE RD.
749-61 76 Ty. P of `Wc�rt1 WATER
Applicant a
required 9r'ee� t.¢ Fur�h she
and to re 1 mbUrse- 'the TcxWn af�
incurred by the Townw ofl id for the amount of -
permit and thatc r mainenanc11 th W .+ dsr � an bond
regulations for ape 1 i Cant 1 s ;. �" or t� rpa i r"�(atok. Y expenses
perm i t;; as. - " farm" i er W"i-th and. w1 1" 1 n connection with
Cut Permit Manua . cttlinet' `iide b this
th the "Torn 'aT fSat y the ru l es and
h Windsor 's Street
* * PERMIT TO gF KEPT F3hl JOB
Issued by _ i .� SITS AT ALL TIMES.
Date C<7m p 1(-r i+ `_--=-=� Tit 1 e
_-__. --- Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
'ermit No. 2478
_ocation AVERY ST. AT TALCOTT RIDGE RD-Address
STATE LINE SEWER & CONST Co
hype Work WATER 238 SHAKER ROAD
ENFIELD CT 06082
Phone No. (860)749-6176
gate Insp Needed kk
Date
ime Insp Needed
7 ie T ns p
nspected By
)rk in Progress
Inpui; � Date �O�r�Slr
APPLICATION FOR STREET EXCAVATION PERM
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm �V1 Phone No. A(o ! 6P
Address of Firm a O Lao
Location of proposed work ®f— c�' ?' db�
Describe fully nature of permit requested r r'�C(-J
Starting date — Approx.time for completion W C>e-- �--
Call before you dig no. qW3 I Qj q-75, 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 �r^�/
Indicate North _ Prop.size of cut 104 10 y 54
\ No.cuts
Amt.of Deposit$2.00• by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing $
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 R€MBURSE 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: (J
d 6111L /
Title: �G� D.L.# ` 03
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES