HomeMy WebLinkAboutWater Street Cut Permits 343 Clark Stree . r
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2724 Contractor TRI-STATE EXCAVATORS INC.
Location 0343 CLARK STREET Address 97C SYCAMORE LANE
Type Work WATER MANCHESTER CT 06040
Phone No. (860)647-9224
Date I nsp Needed I G � .g q�—,-- _ Date '.Insp C�z TI�r
Time Insp Needed 7/ r�S Trrfe gip.
Inspected By -4
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Ps Z"ro• 2724Town of South Windsor CT
06/22/1999
Street Excavation Permit
Expiration Date 06/21/2000
Descrip: CK 1765 $213. 76 CK 1766 6 PERMIT FEES
Applicant Location
Name TRI-STATE EXCAVATORS ARC, STREET
Addr.. 97C SYCAMORE LANE
MANCHESTER- CT 0604Q ;
M ~ y o y Wo` .* WATER
Phone (860)647-9224h . s
Applicant agrees to furaeh} ; � ; yam or the amount of bond
required and to rei mb'ur*e
Towrt B�t�th lAll` ,cr6r any expenses
incurred by the Town fc t
tit n1Jenr�
pa its 6k ri connection with this
permit and that appl icartt a
i de by the ru 1 es and
regulations for permits a 44oUth Windsor' s Street
Cut Permit Manual .
1
* * PERMIT TlpN aL TIMES.
Issued by f ,
T 7 10,.
Date Completed �� �92
" Inspected By _
✓ APPLICATION FOR STREET EXCAVATION PERMIT Z?Z
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm _MZ( SFATip E).CCAVAy QZ-C I UC- Phone No. (e4l —q"IZ 4
Address of Firm on 2— S u GA M o " L.4 &Aa C N ESr&Z
Location of proposed work 34.3 CLA zr- —, ,r C.eT 2
Describe fully nature of permit requested Al, T V lC
Starting date Approx.time for completion
Call Before You Dig No.L -Z •Z- Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut Sx 8' = ,''4'.5.
-3 Wr L aT
No.cuts
Amt.of Deposit$ 2i3 -'76 by
r ()Cash(,I Check# /76 S�
Cut size after Perm. Patch
--^ vyATlsr2•
- Mr}tN No. Cuts
Final Billing$
co T
Amt. Due Payee$
GP(CK. ST
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.
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Signed: v
Date• ZZ
Title• _ D.L.#•
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Pennit.doc