HomeMy WebLinkAboutDriveway Street Cut Permits 155 Farmstea Fsrmit` No. 3026 Town of South Windsor, CT
Date 09i'11l2000 Street Excavation Permit
Expiration Date 09%11 /2001
Descrip;
r
Can t
Locat i orl
Name BLUE DIAMOND PAVING INC 01155 FZARMS1'EAi DRIVE
Addr. 1064 EAST ST NORTH
SUFFIELD, CT 06078 Type of Work DRIVEWAY
Phone (800)728-4644
Applicant agrees to , furnish the Town of South Windsor the amount of bond
required and to reimburse the; Town af' 'South Windsor for any expenses
incurred by the Town for maim®Hance or repair work in connection with this
permit and that app.11 -icant is ..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 .
* * 'PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES. �
Issued by 2 Title
Date Comp 1 eted,r - �—— Inspected By %0, 1r,Ja-'r�i
N6r�'��i, � r5I �•13T ,e
30ZU
k
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm /,o ; Phone No.
Address of Firm P.o•
Location of proposed work 2,TRE �•
Describe fully nature of permit requested
Starting dates Approx.time or completion •
Call Before You Dig No.Q16�23s=y3! Traffic Services.Control No.
Tow sk ich of proposed work or furnish
To be filled out by two copies of separate drawing Town of South Windsor
Pavement Cut
Indicate North Prop.size of cut
ax 3 ld
No.cuts
30 Amt.of Deposit$ by
Cash O Check#
3sx3 av—� �
Cut size after Perm. Patch
a ,
1;4cA \ No. Cuts
`> Final Billing $
a sX S_ Amt. Due Payee
Amt. Due Town$
Applicant is responsible for contacting by date
the Police Dept.and C.B.Y.D.
r /�/�nrr rn I r,IVAa"i;v TH OVVI1 01:30U T H ILNDS0R T HE Ai�I0Ui)T OF C UMJ kt IQUIkEL,AND O REIMBURSE THE i OWN OF
1 PGM1:L �v � _
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 STREET CUT PERMIT MANUAL.
Signed: GG Date• J " CPO
Title:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc