HomeMy WebLinkAboutWater Street Cut Permits 21 Breezy Hill Permit No. 4035 Town of South Windsor, CT
Date 07/12/2005 Street Excavation Permit
Expiration Date 07/12/2006
Applicant ' `•: Lc3cati9n
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Name CONNECTICUT WATEP, CO.MP1XNS' 251 ZBI LZY HF3,L R i�
Addr. 25 NORTH ROAD "
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S WINDSOR r C T.�,
Phone (860)292-5552
Applicant agrees to,..f.... the Town cif .4#01 Windsor tie amount of bond
required and to rekmbu�se ft- yT }� s i{ft u k7f d or fq am e�rpenses
incurred by the Towh for`st '9'Tt; na3""' '`s'`•:Y ''
��g o k"_ztt oaYnec't-'*n with this
permit and that applicant afmzliar iaathz ry 11 ali?e`by the rules and
regulations for permit"s as`.pi Iaed s r i,,•p . :{out ` Windsor's Street
Cut Permit Manual di fk
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4035
Gdntr rt CON [EC. , CFTWATER COMPANY
Location 0021 BREEZY HILL DRIV s
Type Work WATER
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Input _`haa>_ a^'..:: Date
JUL. 12. 2005 7.54AM CONNECTICUT WATER CO NO 303 P. 2
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN.AVENUIE
SOUTH WINDS® !, CT
FEE $25.00
Name of Firm Phone-No�_
Address of Firm- C 7— a eg A-16
Location of proposed W ' 1/
Describe fully nab•of permit requested' ve c vfi
Starting datE __ App=time for completion a.
Call Before You-Dig No. Z.oOS a900 93 0 Traffic Sewlces Centro)No. A.I.*- "
Show sketc#►of proposed work or fuirish0 Z'/ To Town of h Winds 'r
two copies of sepa to drawing
Pavement
Indiczte rth prop,size of cut
No,cuts
Amt of Deposit$ by -
�✓gt k ()Cash ()Check#
STD rP Cut size after Perm, Patch
No. Cuts
Final Billing$
Amt.Due Payee
Arnt:. Due Town$
Applicant is responsible for contacting 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 . WN OF
SOUTH WINDSOR FOR ANY WENSES INCURRED•BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION H THIS
PERMIT AND THAT I Am-FAMILIAR wrM AND WILL ABIDE BY THE RULES AND REGULATIONS.FOR PERMM AS-OUTLIN IN THE
TOWN OFSOUTH'WINDSOR'S STREkT CUT.PERMIT MANUAL,
Signed' Date;,'7
Title; D,L,#;
' 1
JUL. 12. 2005 7; 54AM CONNECTICUT WATER CO NO. 303 P. 1
' e C817fluaveliCH19,110011
NORT14ERN REGION
FACSIMILE TRANSMITTAL SHEET
1O: FROM:
Cathy .Art Plante
COMPANY, RATS:
Town.of South Windsor 07/12/05
FAX NUAMER: TCYrAL NO,OF PAGES INCLUDING COVER
644-7280 2
F=NE NUIMEM Cwc P'AX NUMHEL
644-2511 ex244 1-860-654-1903
3cE: MONE NUMBER
Permits 623-3355 exit. 3355
❑URGENT X POP,REVIEW d PLEASE COMMENT X PLEASE REPLY ❑PLEASE RECYCLE
NOTES/COMMENTS:
Cathy:
We need to replace the shut off valve to the house. We should
not need to cut the pavement. Traffic services will not be needed.
Thank You........ Art Plaute.