HomeMy WebLinkAboutStorm Street Cut Permits 83 Elizabeth St Permit No. 2335 Town of South Windsor, CT
Date 08/07/1997 Street Excavation Permit
Expiration Date 08/07/ 1998
Descrip: SMALL MISC. DR. 97-801 ELIZABETH ST
Applicant jLocation
Name COUNTRY STONESCAPES 008;, ELIZABE"TH STREET
Addr . P.O. BOX 95
MARLBOROUGH CT 06447 Typ�3 of Work',,STORM
Phone (860 )228-2774
Applicant agrees to furnish ~the fow'6 'Of South"�W i n.os,or the amount of bond
required and to reimburse the Town, of South Vtnd,so r ,_for any expenses
incurred by the Town for maintenance or, r pair�w rk .im connection with this
permit and that applicant "is familiar Wfth and w"�" 1 'abide by the rules and
regulations for permits" as ,o t1i"ned "in the""_Town "cif South Windsor ' s Street
Cut Permit Manual .
* * PERMIT TO BE;, KEPT; ON JOB 15,117t AT ALL TIMES .
Issued by _.� •i ..�..�.�,.-" T i t l e
Date Completed _ - Inspected By __ '�
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00 -
Name of Firm PS Phone No.
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting dated Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town of So.Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut f�
No.cuts
Amt.of Deposit$ by
Cash{)Check#i
Cut size after Perm. Patch
No.Cuts
Final BUling$
j Amt.Due Payee$
Amt.Due Town$
Applicant is responsible for contacting
the Police Dept.and C.S.Y.D. by date..
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; N CONNECTION WITH THIS
PERMIT AND THAT'1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Si ed: Date: Y'7 —
Title: D.L.#f
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES