HomeMy WebLinkAboutWater Street Cut Permits 610 Clark Stree TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4060 :: :::...
Contr.ac't`or B AR..BER°'<UT:ILITIES L.L.C.
Location 0610 CLARK STREET Z$'drer ":'P.O,:BpX:331"::
Type Work WATER
5"(12 9
Phone b7oi (s60),8'72' 23:30
Date Insp Needed
Time Insp Needed
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Inspected By
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Work in Progress C io
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Permit No.
Date 4060
08/10/2005 Town of South Windsor, CT
Expiration Street Excav
Date 08/10/2006 ation Permit
Descrip; INSTALL
WATER SERVr'CE`"
Applicant
Name BARBER UTILITIES; L Location
Addr. P.O.BOX 331 L C
6Slti CLARK S
ELLINGTON CT TK$ET
k.
Phone 0602R
(860)872-2330 TYfe of jai
WATER
Applicant agrees to f
required urriash the and to reirl'�rSe Tofu crf South Wind
incurred by the Town fear e ji,, yuth T?73n gar caz. the amount of
ma: iysn bond
Permit and that applicant a,s acn is or fo .... uses
repair iacark a p regulations for permits as;.. otdt with
Cut Permit amide b this
Manual. ixy theb y t 'e rules
and
S'o r s
St
reet reet
PERMIT TO `$ KE�T •ON JQgIE;AT AI.LL TIME.
Issued by
Date
Completed
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— ----------- Inspected By
` APPLICATION FOR STREET EXCAVATION PERMIT 4o�c,
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm � rs Ui%L/ TJ,� _ L,Z- Phone No. 960 20 7Z-12-L o
Address of Firm Fc i? k 3 5l
Location of proposed work &/ 0 C Leq-YO-IL
Describe fully nature of permit requested rN,-1fi-Le 1t/zuJ ��ff'j��2 ✓t
Starting date_ 6---14 --o S Approx. time for completion C)IV
Call Before You Dig No. 5 3 2 0 c' 7 5 9 Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
Est.Size of Perm. Patch(s)
LEI
Est. Pvt.Thickness in.
Est.Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check#
Permanent Patch
No. Cuts
�� � --- Size of Patch(s)
Final Billing
Amt.Due Payee
Amt. Due Town
$
By
Applicant is responsible for contacting 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 W H THIS PE AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS O INED IN T E WN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Lv Date: R
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES