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HomeMy WebLinkAboutDriveway Street Cut Permits 321 Benedict ,w,, ? 2382 Date 11/05/1997 Expar°ation u. Town of South Windsor, Date 11/0.5/1993 Street Excavation Permit Descrip: WORK ALREACY COMPLETE x Applicant Name LEWIS Addr, PAVING CO, Location 52 BURNSIDE AVE OS2X BENEDI E, RARTEORD T DRIVE Phone (880)528- CT U61G8 5`_O4 Type of Ware "pRTVEWAY Applicant agrees to fi required and to reimburser' the . incurred b the Town Town of+ 5oU h Windsor Y the Town for of .©uth W�- d the amount of bond Permit and that maintenahce n s6r -far an regulations for, app i i Gant i s. or repa 7 r:w Y expenses IamI"lz� r twit. c� k " in connection with t Cut Permit permits as`'4Wt1 ir►ed i t1 and "w� 1�. abide b his Manual . the "Town of Y the rules and South Windsor 's Street * * PERMIT TO 3E KLPT 'N Issued by _--___.!� `_ �1t7B SITE AT ALL TIMES. Date Completed -� T.it1e Inspected SY APPLICATION FOR STREET EXCAVATION PERMIT �� PUBLIC WORKS RKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm S' ��G ��/` Phone No.— � Ll Address of Firm /~GY �• Location of proposed work 3A( &6-(en ey oK - J Describe fully nature of permit requested ��(, 6J Starting date Co N 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 04 No.cuts Amt.of Deposit 8 by O Cash()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.S.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 I AM FLIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTTWINDI;Rt�STREET UT PERMIT MANUAL. Signed: Date: - Title: D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES