HomeMy WebLinkAboutNew Sanitary Lat Street Cut Permits 401 Permit No. 3008 Town of South Windsor, CT
Date tOS/02/2000 Street Excavation Permit
Expiration Date 08J02/2001
Descrip:
Applicant Location
Name DUFFORD CONST COMPANY,
�401 "C IAPEL ROAD
Addr. 240 COMMERCE STREET
GLASTONBURY CT 06033 " Type of. Wrrk NEW SAN LAT
Phone
Applicant agrees to �FUr��sh tl 7C1G�Ql p Sowth Windsor the amount of bond
required and to reimburse tPe .Tow,n aduth Wr,rtlsor for any expenses
incurred by the Townfrnter repay ,a+ rki h connection with this
permit and that app l ,ca`h V° Ts�E^f amp ,star, O.� an 1 abide by the rules and
regulations for permi":tt.....as � t4 ` 1'tfi': t Toarr Qf " outh Windsor 's Street
Cut Permit Manual .
* * PERM�I�T' TO BE KEPT I'E ,4T :ALL TIMES.
Issued byi' Title:
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm o4 1. Phone�,,Nqq
Address of Firm ®
Location of proposed work p
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig N O Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
t Amt.of Deposit$ by
C O Cash O Check#
Cut size after Perm. Patch
see �
NO. Cuts
Final Billing $
Amt. Due Payee$
Amt. 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 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: 11 Date: 8 ! 9,0
Title:
PERMIT SHALL BE KEPT ON 30BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Pennit.doc