HomeMy WebLinkAboutCurb Cut for driveway Street Cut Permits BOND TOWN OF SOUTH WINDSOR 899
It Req. PUBLIC WORKS DEPARTMENT Date
TOWN HALL
}; m't on File 1540 SULLIVAN AVENUE Permit No.
SOUTH WINDSOR,CT 06074
Date of Expiration Permit Expires
APPLICATIO OR PERMIT
FEES a ck 6
Name and address of applicant f -012-s L, Phone No. 2S Z D
Location of proposed work o D S
Describe fully nature of permit requested ve uP
Insurance on file h Town no Date oli p cy expires
c Name of Insurer wi ..e
o Approximate time for completion f 1j, Desired starting date
Call before you dig ticket No.
t)
a Show sketch of proposed work or furnish 2 copies of separate drawings
a
PIA-
0
c
0
14
v
Q
N
O
O ..
O
i+ t
44
cd
U
a
4 Applicant is responsible for contacting the Police Department and CALL BEFORE YOU DIG.
I agree to furnish to the Town of South Windsor the amount of bond or deposit 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 (Pavement Cut Regulations.)
Signed
APPROVED. DATE APPROVE
DATE
Supt. of Highways
P
FOR INSPECTOR: Date work started Date completed
. ,.
Sufficient-noti ication'received: yes no Type of repair: -Perm. Temp.
Unusual conditions encountered
Material slips attached: yes no Dated for Permanent repair
Signed
Inspector