HomeMy WebLinkAboutDriveway Street Cut Permits 340 Benedict Permit No. 3093
Date 04/23/2001 ,RAG- � Town of South Windsor, CT
Street Excavation Permit
Expiration Date 04/23/2002
Descrip:
Applicant Location
Name COLONIAL PAVING
Addr. 244 LOMBARDO DR
E. HARTFORD CT 06 1"18
Phone (860)568-9613 Type of Work DRIVEWAY
Applicant agrees to„furt7.Sh the T6' Wn ,Of South ,Wi duor the amount of bond
required and to re ell Towh` ,QflSouth Windsor for any expenses
incurred by the Town fort� to t no `or ,49- i r" Vvtirk i h connection with this
permit and that applicatt ,i� far ��ar °wit�ti and wi�l:1 abide by the rules and
regulations for permsts `°'as ctaD, � ,n t
he: 'Town o South Windsor's Street
Cut Permit Manual .
* PERMIT TO E KEPT CN �,1Og TTE 'A`T' ALLL' TIMES.
Issued by ,� Title
Date Complete 0--- 2Z GJ Inspected By�
40 j 19�4 d
C�"'
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT �D�3
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm CQ(.DAI/r4(• )PA i✓A06- (:d, pE , ' hone No.
Address of Firm .2qV Lom,B iQ p AR. E, (2-- ,
Location of proposed work sq4,/O ENE113�T b R �0 W/ .0509 Cam'
Describe fully nature of permit requested PRt/I r0 R I d�Gc1/41/
Starting date -2,V o/ i� Approx.time for completion ON
Call Before You Dig No. ..?0 0//6 0 Q 83 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor two co P ie Com-lete-Descri t o orxto b�ertormea
p p
Pavement Curt
Indicate � n — _ -„- Prop.size of cut
No.cuts
------ ---- - ---- - - - — Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
- -- - -------------- --- -- No. Cuts
___-- -- -------.,---- - Final Billing$
----- ----- --------------- - - ---- Amt. Due Payee$
Amt. Due Town$
Applicant __-- by date
the Police Dept.and C.B Y D.
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 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- q
p Date:
Title:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
—- - Standard Forms\Permits\Street Excavation Permit.doc