HomeMy WebLinkAboutElectric Street Cut Permits 11 45 Fitch TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No aZ250 ;, , Contractor WETHERSFIELD CONST CO
Location "" & 4t TCH M Address 1 WELLS ROAD
Type Work ELECTRIC WETHERSFIELD CT 06109
Phone No. (860 )529-5224
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Time Ins
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Work in Progress rt1
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Input ' Date (0-A D�
Perm. Pl, „ 3250 Town of South Windsor, CT
Date ' 03/14/2002 Street Excavation Permit
Expiration Date 03/14/2003
Descrip: INSTALL NEW STREET LIGHTS
Applicant Location
Name WETHERSFIELD CONST CO 71 <45 FITCH MEADOW LN
Addr. 1 WELLS ROAD
WETHERSFIELD CT 06109 Jype,., of Work ELECTRIC
Phone (660)529-5224
Applicant agrees to f"urn�skr 'the "fiowr '"af Sauth Windsor the amount of bond
required and to reimburse 'Towin `t,f S,oUth WJ"ndsor- for any expenses
incurred by the Town form enance or `,r pair� a% rk.,. in connection with this
permit and that appl i ca'rt ."i;;�s;fa :, t� VI' h and",'will -abide by the rules and
regulations for permits ass r `` �n` .South Windsor's Street
Cut Permit Manual . ,
* PERMIT TO" BE "KJ=PT OPl JC18 SITE,.AT ALL TIMES.
Issued by . Tit"1®. . �G.
Date Completed Inspected By ,,,,,�,�� `, �
# 3260
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm V(iHC1W1CriJ T. e _ Phone No. ��9- 5-,2. ¢
Address of Firm / 01—cL1r /ZvA D kt-G THrMj/c/C10 C ®G 10 7
Location of proposed work // f ¢S `��c y r-14
Describe fully nature of permit requested C- RSA« /h,,2 I tiCti S Taco T 614 1Y>1 :t /o" C46tl Lo�471,.,.
Starting date -7, A 7• o Z. Approx.time for completion r&
Call Before You Dig No. 2 co z //n IF 6 y Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North u Al Prop. size of cut
L'_ No.cuts
Amt.of Deposit$ by
Cash ()Check#
2�w
Cut size after Perm. Patch
A No. Cuts
A L qD,,
Final Billing $
Amt. Due Payee$
Amt. Due Town $
Applicant is responsible for contacting by date
the Police Dept. and C.B.Y.D.
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.
Si ned: -�- r �
9 Date:
Title: �� �i��s r/h ^-7 D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc