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HomeMy WebLinkAboutWater Street Cut Permits 335 Clark Stree Permit ' Jo. 2727 Town of South Windsor, CT Date,, 06/22/1999 Street Excavation Permit Expiration Date 06/21/2000 DeScrip: CK #1764 $614. 56 CK#1766 6 PERMIT FEES Applicant Location Name TRI-STATE EXCAVATORS ;I IN .` �35{ CLARK, STREET Addr. 97C SYCAMORE LANE MANCHESTER CT 06040 'Ty peof, Work WATER Phone (860)647-9224 Applicant agrees to--furnish tho Towri 'of South Windsor the amount of bond required and to reimburse the(1 Town of �'Sbuth W�i.t�clsor° for any expenses incurred by the Town for maintenance or.- repair work in connection with this permit and that appl i'caht is"I famJlil it I=with and' wi l l ,abide by the rules and regulations for permits as >'buit l'i,ned 1 it ei` Town of South Windsor's Street Cut Permit Manual . *: PERMIT T E KEPT ON JOB ,TTE AT ALL TIMES. Issued by T i t l e -�� Date Compl dtd -7 F 6 Inspected By ~ TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 2727 Contractor TRI-STATE EXCAVATORS INC. Location 0335 CLARK STREET Address 97C SYCAMORE LANE Type Work WATER MANCHESTER CT 06040 Pho,hl le= „No. (860)647-9224 Date Insp Needed 7�G/,S' Date in sox, 7��9 p 11 Time Insp NeededInsp. Inspected By / /, Work in Progress l�y, `:�c c e� �r.�A ,� .C� �. -jam'" �O let , 010, Z►oo o ��- M�srrxy� ��ro%��-o .� �i f:©��. l ���rs InpU. Date ( kjao APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $2S.00 Name of Firm -M-SrATE E:MAUA Torzs 1 N G', Phone No. 643 q Z2 4 Address of Firm a 7 C SnCA 2 C 7" Location of proposed work 4 6 S cd.A¢.k. ST Lo r 3 Describe fully nature of permit requested Starting date--AM f rf 7 Approx.time for completion Call.Before You Dig No. 3 Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of South Windso two copies of separate drawing 1�-� Pavement C Pro ut Indicate North � Sr•-- /�'� �' = !zo r ��y ^�. p.size of cut d✓'9 t gA a y 33S C,L#,(LL sr No.cuts L.o T- v Amt.of Deposit$ e S 6 by C EIX F OF {)Cash 00 Check# /79" p J T 0. y PU)114l- C Cut size after Perm. Patch b. r WATER 144A,it3 No. Cuts Pao Portz a 9�7 S e 3(S7,&. Final Billing$ Amt. Due Payee$ Amt. Due Town$ Applicant is responsible for contacting by date the Police De .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. r Signed: Date: Title: D.L.#: I'7 Zip L j PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation.Permi#.doc-_------