HomeMy WebLinkAboutWater Street Cut Permits Clark Street fr Permit No. 2509 Town of South Windspr , CT
Da'te=�, 1 1/02/1998 Street Excavation Af®rFWi t
Expiation bate 1110211999
`DF?'sc �rip: WATER MAIN FROM ELLINGTON TO POST OFFICE
Applicant Location
Name H .M. NUNES & SONS CONS NC'. ST11T FROM ELLINGTON 50.
Addr. 27 GAMACHE DRIVE
LUDLOW MA 01-056 Type �f Wor'k`- WATER
Phone (413 )547-6488
Applicant agrees tq ffrn h f
f jn,dor the amount of bond
required and to reimb r ;, � i6wn � n -r any expenses
incurred by the Town for ►rk ier connection with this
pa 1 F
permit and that app l i ar t i i mi
regulations f rJ r and i de by .the rules and
per misµ � Towtth Windsor' s Street
mit Manual .
Cut Per
i a <% ,
5
W lSk fight `' ,�
2o-
* PERMIT T� E P
�A TIMES.
3 $
Issued by
Date Comp 1 eted� '
-- _ Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2509 Contractor H.M. NUNES & SONS CONST. INC.
Location CLARK STREET FROM ELLINGTON SO.Address 27 GAMACHE DRIVE
Type Work WATER LUDLOW MA 01056
Phone No. (413)547-6488
Date Insp Needed
Time I nsp Needed Tate J. risj ,w
Inspected By
4ork in Progress t>s$ . "���i G�� fN�P�G-c►onl P P Ts:""
Input` Date
z
APPLICATION FOR STREET EXCAVATION PERMIT
t TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm f"� iL SG��f� t L i, Phone No.
Address of Firm 2 ( r h\A rl C 14 E //)2. % 0,4 e�
Location of proposed work C`L-/may S r
Describe fully nature of permit requested 77 0�
Starting date // Approx.time for completion !!Z/���y
Call before you dig no. 0 2 el ys 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 Stid ZS r `
No.cuts
p p �✓/��' Amt.of Deposits! by-j e-T
()Cash N'Check# 68E34—
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee S
Amt. Due Town 8
Applicant is responsible for contacting
the Police Dept. and C.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO R}IMBURSE 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: %_.., 74� It %� � ) Date:
Title: `' D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
L