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HomeMy WebLinkAboutWater Street Cut Permits 307 Clark Stree Prmi is' No. 2728 Town of South Windsor, CT Date 06/22/1999 Street Excavation Permit Expiration Date 06/21/2000 Descrip: CK #1761 $614. 56 CK #1766 6 PERMIT FEES Applicant Location Name TRI-STATE EXCAVATORS IC0AF°} STREET Addr.. 97C SYCAMORE LANE a ;� MANCHESTER CT 0604C ` , WATER Phone (860)647-9224 .f Applicant agrees to ;` vf�r i the " p ut i 1tVI foor the amount of bond required and to reimbfu tow fir ' i _fbr any expenses incurred by the Town t �er1e , fepaT " - , n connection with this permit and that appl aml� ysrt and ri 1, aside by the rules and regulations for permits a1 T;owm of �pth. Windsor' s Street Cut Permit Manual . � PERMIT TO BE IM P 0 tfE A�'� AFL TIMES. Issued by, �tle Date Completed 7 nspec` 6d,/By i TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 2728 Contractor TRI-STATE EXCAVATORS INC. Location 0307 CLARK STREET Address 97C SYCAMORE LANE Type Work WATER MANCHESTER CT 06040 Phone No. (860)647-9224 Date Insp Needed Date ''Insp- Time Insp Needed �leia�5 Tirrie Insp. Inspected B Work in Progress x �AelJA k� n Input Date J APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm_lkl -5TATIF- O(CI°+U TDtZS Phone No. Address of Firm R7 Cr S(1CAJ-rt oR.0 LA PMAXNESMR- (T Location of proposed work 301 d L.Ae4 PTRzr. LAT (o Describe fully nature of permit requested tU.. AT R- V tC ft,� fl_ �7-ER.'i41 Starting date Approxc time for completion Call Before You D g.No.1Qgq ZSD?- 318A - Traffic Services Control N©. Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate drawing Ill Pavement Cut �s--e Indicate North Prop.size of cut 8 x S COT- No.cuts Z Amt.of Deposit$ 6/fol by exe-a: Pumr. O Cash(xf Check# L7�/ s b. A.0fife� Cut size after Perm. Patch d' 4-6�-i► 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 WINDSORIS STREET CUT PERMIT MANUAL. 1 Signed• , &41 Date: Title: 71)D.L.#: �7 04; PERMIT SHALL BE KEPT ON 306SITE AT ALL TIMES Standard Forms Permits Street Excavation_Permit.doC_-_--