HomeMy WebLinkAboutSanitary Main Street Cut Permits Heritag Permit No. 2301 Town of South Windsor, CT
Gate 05/ 16/ 1997 Street Excavation Permit
Explr ;.�tion Gate 05/ 16/ 1998
Descri p! CROSS COUNTRY SPkiER MAIN
Applicant Location
Name J & H; $LATER t.ONST CO ✓=TELDTONc. ,, SEWER MAIN
Addr. 75 COMMERCE WAY
SOUTH WINDSOR CT 06074 Type of .WorK SAN MAIM
Phone ( 860)528-5252
Applicant agrees to fur.ni'sh the Town of South Windsor the amount of bond
required and to reimburse the Town of South Windsor for any expenses
incurred by the Town for piaintenan or r pair "woo Inconnec��tion with this
permit and that app i i cant "is �fam! l i are- w i th and 'w i:l l abide by the rules and
regulations for permits ' as outl,Y,ned 1n the Town of South 'Windsor ' s Street
Cut Permit Manual .
* PERMIT TO BE KEPI" ,0N JOB SITE AT ALL TIMES.
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Issued b y ---- --
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Gate Completed ... Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
� PUBLIC TOWNS DIAE�L RTMENT
1540 SULLIVAN AVENUE
--- SOUTH WINDSOR, CT
FEE 25.00
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Name of Firm /� lf✓L �j% t rQ ,�'. Phone No. Sze-S'L,SZ-
Address of Firm C
Location of proposed work
Describe fully nature of permit requested 1AJ ajocge- 7 dL. l f�
Al"111191 dAl
Starting date Approx.time for completion CGS
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut e
izV./8, � No.cuts
Amt.of Deposit$ by
Cash()Check#
Cut size after Perm. Patch
No.Cuts
Amt.Due Payee$
Amt.Due Town$
Applicant is responsible for contacting
the Police Dept.and C.B.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 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: Date• 175-16—97
Titl D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES