HomeMy WebLinkAboutWater Street Cut Permits Collins Crossin Permit No. 2349
Date 09/ 15/ 1997 Town of South Windsor, CT
Street Excavation Permit
Expiration Date 09/15/ 1998
Descr i p; WATER MAIN OFF NEVERS
Applicant Location
Name WOOD CONSTRUCTION OULL,IN ., XI1G MAIN
Addr . 223 WOOD ROAD
BONERS CT 06071 ' Tye 0 4f Wci�k WATER
Phone (860 )763-4185
Applicant agrees to furnish the Town -qf S6,Uth 4i,ndsor the amount of bond
required and to reimburse the Town of SO ''t W'Inds or for any expenses
incurred by the Town for rRa'intenanoe or"; repair `work i n'' connection with this
permit and that applicant _ s, fami l,lar w$,t"I and 'w 1'i abide by the rules and
regulations for permits as 4u.t1 tied- i;,; tli+a Tawn_ df
Cut Permit Manual . ;Both Windsor'sStreet
* * PERMIT TO BE KEPT ON JC?B ;SITE AT ALL TIMES. �
Issued by .Title
Date Completed _--- _--- Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm `IJC yo CO niS•rev c.-r%Q0 C o SSG Phone No. ?ilo0- 7(03 y�$rj
Address of Firm ZZ3 wOOD �„F„ Sa, .`rz� CT �(00"1k
Location of proposed work
Describe fully nature of permit requested
Starting date a1(Zz Cyj Approx.time for completion
Call before you dig no. CC-)"37o z,I3 Traffic Services Control No.
Show sketch of proposed_work or furnish To be filled out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut �le Z
No.cuts
SL C ?L-A ram{ Amt.of Deposit$ by-
Cash
O O Check#
Cut size after Perm. Patch
No.Cuts
�a
�/v v Final Billing$
Amt. Due Payee$
6r/
Amt. Due Town $ -
Applic
e
the Pol w by date
I AGREE TO ✓` `t 'e� MOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SOUTH WINI )R MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS
PERMIT AND ar rHE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SD _ ntET CUT PERMIT MANUAL.
Signed: `� �. -"`1 Y Date:--
Title: �rZvS�C T MUD. D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES