HomeMy WebLinkAboutTelephone Street Cut Permits Quarry Broo 800007 TOWN OF SOUTH WINDSOR, CT
MRMIT NUMBER STREET CUT PERMIT
DATE: 02/14/08
GIS ID: 74109999 `y` •"> <:` '£';
,:: FEE: 25.00
MUNIS APPLICATION# 200800145 '; ::: <`;""` E ?IRATION DATE: 02/25.00
LICANTAPP ---`'
OCATION
NAME: CABLE CONSTRUCTIONf).>CY<` f' `" ;ADDRES ",rc'..; TARI;;BROOKDRIVE
ADDRESS: 405-D NEW STATE WAD ..... „>f'< ^„, >.>.<.. .:.
ER ' ': <°:' fQtVVN OF<SOUTH WINDSOR
CT 0 0,91 :" $'<: 3 40-,S
MANCHESTER 1VAN A n VE
'S01, 'H yl�I tDSOR CT 06074
PHONE 860-649-8217 ,.�;<.:::::;:+.:,:,.:'>::.
WORK DES
CRIPTION:
PTI ON: MULTI
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< R,:.. �:..�; �����? .� GE .00ATIONS ON ST
SHADa :£ VIO.<:,•:,F,.FF ?. t�IKED AND COVERED
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APPLICANT AGREES TO FURNISH THE i"6WN O Q JFI . T(7YjI 'I* FBONE)REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC'Eh1?I � IN .: 'I?'> ' -TOW POR.MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI?:APPZ�M-T'N"; ; 'ZI ;X� MIDI;ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OI �SdU VINI: t..',5 RR.F,eC P RIY1ITy1VIANUAL.
ISSUED BY �V
DATE°INI?yECTE INSPECTED BY
2/14/200810:29AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: L6 c9 0117
CONTRACT"OR:_
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED; DATE INSP:_ l/ap/v7
INSPECTED BY:L,
WORK IN
PROGRESS:
AS-BUILT:
INPUT: DATE: q ' m,
WJ2007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT �voa�r7
TOWN.OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
�ip7 o2O0 g 00/YS TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
0 4v67,11 FEE $25.00
Name of Firm v16,rvv00a VL 6 L/ f
.Phone No. "
Address of Firm �} T
Location of proposed work
Describe fully nature of permit requested JC
Starting date - Approx.time for completion
Call Before You Dig No Traffic Services Control No.
Show sketch of proposed work or famish
two copies of separate drawkV Indicate North
This section to be fitted out by
Town of T South'Wind sor
Pavemnt Cut
No.cuts Swtr�r I.
Est.-Size0fP Pats)
Est.Pvt.Thickness in.
Est.Unit Price$
Amt.of Deposit a
_ To Due$_a" by
t )Cash t )c #4 s
Permanent Patch
No. Cuts
Size of Patdxs),
Final Billing
S
Ant,Due Payee
a'
Amy.Due Town
. - By ,
Applicant is re nsible for cwtacting
_ he Police De t:and B.Y.D.
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 TH THI P BAIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS O IN. I WN OF SOUTH WINDSOR'S STREET CUT PERMIT'44ANUAL. ,
5
Si ned: p.
Date: � �tr� ®o •
Title'.
Dlvees License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES