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HomeMy WebLinkAboutElectric Street Cut Permits Chase Farm S 22 Date 64 1 1/ 15/ 1996 down of South windsor, Expirat�ion Date Street Desc-- Excavation Per-mitl )rip: U-1 [LIT') CR0sL;jNG FOR, I L I TIES Applicant Name PAGANI CONST RUB;TION Locacican Addr. 15 KING STREET CHASE FARM SUBDIVISION ROCKVILLE CT" 06066 Phone (860)872-7757 Type Of Work ELECTRIC Applicant agrees to 'furvilsh the T required and to reimburse Own 'of South WindSor for a incurred by the Town ' 0 1 r ''the Town, of South Windsor, the amount Of bond MaInten,eince or rep nY expenses Permit and that � I ' air Wbrkin connection with this app I cant js fam'i I i ar I With regulations for Permits th,: and will,Cut Permit Manua-l . ,as in th abide by t Town, of he rules and South Windsor's Street PERMIT TO BE KEPT ON Issued b 'JOB SITE AT ALL TIMES. Date COMP leted Title1 J- 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 �s Phone No. Address of Firm C rS^ ui 6 11 a Chi- O 6 c' Location of proposed work wcZ T1 o I e 3 b Descr�ibe fully nature of permit requested E7XCI'!V ITf- - ! gLA N LA. C21 r� �(I1K 1ctS t f� _ l ?-I % 1 eya T12enj elk Starting date M t A). i e N riy , Approx.time for completion l �} Call before you dig no. Zi � 4 6 U Z O b 9 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 0 y4 U,8D by �So/fr� 1, 3Dh18eo- , (_ ()Cash N'Check N I Cut size after Perm. Patch I� N I No.Cuts Final Billing S Pis Amt.Due Payee 0 �� 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 REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT T I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN F SOUTH INDSOR'S UT PERMIT MANUAL. Date: 9 cO Signed: 2- 1 � �7 � Title: D.L.N ©2. l PERMIT SHALL BE KEPT ON J08SITE AT ALL TIMES