HomeMy WebLinkAboutWater Street Cut Permits 12 Crestwood Dr TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3745 Contractor CONNEftICUT WATER COMPANY
Location 0012. CKNS At3rlre is25 NORTi:: ROYD.;.
Type Work WATERAS;T WINDSOR CT':06088
Phone No (",q),;.292 S,552
Date Insp Needed --_------_� T Date Txa�p �r
Time Insp Needed _----- Time Tns
Inspected By
Work in Progress — � � 4 '1 g. 6 tie
Input — Date
Permit No. 3745 Town of South Windsor, CT
Date 06/02/2004 Street Excavation Permit
Expiration Date 06/02/2005
Descrip:
Applicant Lt3caCion
Name CONNECTICUT WATER COMPANY, A012; CREST:WOOD,DRI�7E
Addr. 25 NORTH ROAD
EAST WINDSOR CT06088:. yPsf Work WRT.ER
Phone (860)292-5552
Applicant agrees to fttr ash :fihe:Totivn of Out Windsti<� the''''aihGunt of bond
required and to reimburse':the Town of;;8outh; W� Isor for and expenses
incurred by the Town for maim nan ar r ix Vork i .conne,c:ti n with this
permit and that app3cant:;.aS familiar with and 01,11 gbade b:y the rules and
regulations for permits:"as 0WA. Scsuh Windsor's Street
Cut Permit Manual.
* * PERMIT TO'BF KEPT ON, T Aj,r TAMES '
Issued by ----�_ � Title
Date CompletedTn:spetted By �A V
JUN. 1. 2004 9:OOARPLICCONNECTICUT WATER_ JEST EXCAVA`PION PEk 8K P. 2
TOWN OF SOUTH WINDSOR
PUBLIC WORDS DEPARTMIEW 3
TOWN HALT.
1540 SULLIVAN AVENUE
SOUTH WINDSOk Cr
FEE $4.00
Name of prm /i cv 71'- b✓ lo!— o phone No. Z—33
Address of Firm 2 5 �
n
Location of proposed w
Describe Nally nature of permit requested e
Starting date Approx.time for•completion 9e
Gall Before You Dig No. 2p 2Z03 alo R Traffic 5WAM$Control No.
Show sketch of proposed work ftai ish To be fill!ed out by Town of South iffladsot
two copies of s—eparzte drawing
�,-
Pavement t�u' t •
Indlr_ate North Prop,size of cut X /�
No.cuts
Amt of Dew$ by
�Z ()CBSh()Check# .
Cut s¢e after Perm. patch
No. Cuts
. Final Biping�
Alit. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting by date
the Police Dept.and C.S.Y.D.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRer)AND TO REIMBURSE YNi=TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORKAN CONNEMON WITH THIS
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULM AND REGULATIONS FOR PERMITS AS OUTUNED IN THE
TOWN OF SOUTH WINDSORS STREET CUT PERMIT MANUAL
Signed: Date;
ntte;
PERMIT SHALL.RE KEPT ON 30BSM.AT ALL TIMES
Smndard Forms\Permits\Street E=vatlon PermlLdoc