HomeMy WebLinkAboutWater Street Cut Permits 88 Barber Hill Permit No. 3984 Town of South Windsor, CT
Date 05/19/2005 ,Y.t<. :<•,,,;x.;<: .
Street Excavation Permit
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Expiration Date O 5/19/2 0 0 6 �r
Descrip: INSTALL WATER SERVI C
Applicant
Name COVEN CONSTRUCTION <COs>'""`"" a='
P.O. 8 BARBER #[ , LRC3Ab
Addr. BOX 427ay,_
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06
COVENTRY CT
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Phone (860)282-0526
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Applicant agrees o. €>uzY} a3 the
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required and to re' m33se C1 ? t Ior r afi
9 Y:. Penses
incurred by the Toc3n
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ors ` � "`"'" <
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permit and that a 6 'if?z pu ec t 'on with this
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ftqw >>' .. pa ' cue -by>the rules and
regulations for permits a:s`wca�}:;li'rret<-:. : 'thy€ "�yxr'o' "`Syh: ;.hcsor's Street
Cut Permit Manual.
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Issued by
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Date Completed __- Inspected By � �
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3984 Colter or CO IT-C.INSTRUCTION CO.
Location 0088 BARBER HILL ROAD rAddreq$ ¢'%v P.Q gB 427.,
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Type Work WATER �VENf`F:Y;; T .052.38
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Date Insp Needed - -
Time Ins `>p Needed �L\.( � ;rat :` � R"T: t
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Inspected B
Work in Progress
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APPLICATION FOR STREET EXCAVATION PERMIT39���
TOWN OF SOUTH WINDSOR —
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm � �
Address of Firm Phone No.
Location of proposed work 3
Describe fully nature of permit�f equested
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Starting date aZ (� ;
Cali Before You Di No._ J --- Approx.time for completion a
Traffic Services Control No.
Show sketch of proposed work or fumish
two Copies of separate drawing Indicate North This section to be filled outby
Town of South Windsor
Pavement Cut
No.cuts
Est.Size of Perm.Patch(s)
' t x Est.PvL Thickness Z in.
Est..Unit Price S,
Amt.of Deposit
Total Due S by
( )Cash
Permanent Patch
No. Cuts
Size of Patch(s)
iz
By
Applicant Is responsible for contacting
the Police De L and C.B.Y.D. Date
I AGREE T RGTOTOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF.S OR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION IIT AND THAT I AM FAMILIAR WITH AND WILL IDE BY THE RULES AND REGULATIONS FOR
PERMITS A TOWN OF SOUTH WINDSOR'S STREET CUT EAMI mANIjAL.
Signed: Q
Date: 0
Title:
Driver's L' se#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES