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HomeMy WebLinkAboutGas Main Street Cut Permits 102 Bridle W Permit No,' 2324 t Date 07/30/1997 Town of South Windsor, CT Street Excavation Permit Expiration Date 07/30/1998 Descrip : EXVAVATE TO TURN ON WATER Applicant Location Name CONNECTICUT WATER COMPANY ' Addr . 25 NORTH ROAD � �10 - RIDL •,WOOD ROAD EAST WINDSOR CT 06088 Phone (860)292-5552i 'SAS Applicant agrees tt fug of sh 'the ficawt� �f required' and to reimburse ",'the ,l"own ref 9u�thWtpdsor-fororanye amount expensesof bond i ncurredi�by.\the Town for main' tenancy ©r' permit and that applicant ,is` with thi famY ,artpand ` 11akide, tnconbyc the nrules ands regulations for permits as Out ironedtheTowrc�f .,Souith Windsor 's Street Cut Permit Manual . Pd),RMIT TOf EPTdN JOCK 'SIT A-T ALL TIMES. Issued by Date Comple�\ed ` Inspected By _ APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm I CD Phone No. Address of Firm Location of proposed work Describe fully nature of permi requested Starting date — Approx.time for completion C4 _ Call before you dig no. Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of So. Windsor two copies of separate drawing Pavement Cut Indicate North Prop.size of cut No.cuts Amt.of Deposit$ by 1 O Cash O 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 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: Date: 7 A '(I 7 r Title: D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES