HomeMy WebLinkAboutMiscellaneous Street Cut Permits Avery S Permit No. 2417
Date 04,/14/1998 Town of South Windsor , CT
Expiration Date Cr4/ 14/1999 Street Excavation Permit
Descri.p CUT AVERY ST 8" & WIDEN ROAD, ALONG,, CUTLER UTLER RIDGE SUBVISION
Applicant
Name SIMSCROFT ECHO FARMS Location
Addr. P.O. BOX 581 AVERY ST AT CHANDLER ST
SIMSUY CT Phone (SgD)6,R- 1_028�60 70
Type of Work MISCELLAN
Applicant agrees to furnish the, Town of Sou,t' w
required and to reimburse 'the 'Town ofouh Windsor for
�ndspr the amount of bond
incurred by the Town for
Permit and that a maintenance ar r® air any expenses
p wror� '' i n' connection with 'this
regulations for applicant is familiar with and .wiliabide b
Permits as outlined 16 the Tawrt' of South Windsor 's
Cut Permit Manual . Y the rules and
Street
PE 'MIT To BE KEPT ON :JOB
Issued by SITE AT =ALL TIMES.
Date COMPleteidi
Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
` TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE All
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm -r Ms C Yv r f— A=r-X v 9101.-r•
Phone No.
Address of Firm 0 .•.7a S 6r Cam'.
Location of proposed work_
Describe fully nature of permit re nested 0 1U S t
c�BDic/d SioxJ
7^-GQ Approx.time for completion
Starting date w-
Call before you dig no. /8 / 3 G 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
No.cuts
Cf✓v7L.t'—j2D4E Amt.of Deposits by
Sv 3D/U/S✓0/U
() Cash () Check#
Cut size after Perm. Patch
No.Cuts
Final Billing $
Amt. Due Payee S
Amt. Due Town 6
Applicant is responsible for contacting
the Police Dept. and C.S.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO RQMBURSE 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:--
4_14 90
Date:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES