HomeMy WebLinkAboutWater Street Cut Permits 1028 Foster Str •- TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2678 Contractor STATE LINE SEWER & CONST CO
Location 1028 FOSTER STREET Address 238 SHAKER ROAD
Type Work WATER ENFIELD CT 06082
Phone No. (860)749-6176
Date Insp Needed '/�ITg -- .S l P
T/ 9 Date 'Ins
-5 .s�T/99
Time Insp Needed
Time Inspt•�(_
Inspected By,
Work in Progress
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Perrrajt- No. 2678 Town of South Windsor , CT
Dt, 05/07/1999 Street Excavation Permit
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Expiration Date 05/06/2000
Descrip: WATER SERVICE
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Applicant Location
Name STATE LINE SEWER & CONST 60", FOSTER STREET
Addr. 238 SHAKER ROAD
ENFIELD CT 06082 x ` "` `�fiype; c�1 4IQ
r+k WATER
Phone (860)749-6176
Applicant agrees tQ furnsi~t ;tieET� .,f S� 4�1i ndlsor the amount of bond
required and to reimb ►'^ � -�, Tnw� m3 f4iasor or any expenses
incurred by the Town fa i, tnance �_ rizi 6 connection with this
permit and that app 1 act arxp } i de by the ru 1 es and
regulations for permits �air�* " Toh0 " Spth Windsor's Street
Cut Permit Manual . �� d ` �" m k
* PERMIT '�TOT � � k TIMES.
Issued b .6^ �� � "� ^,✓�" � � �� � ' '"� ,1,, '�� \9�
Date Completed ��/�4 � k � `�`' Ir�spaeted By -
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm r-ev efam Phone No.
Address of Firm
Location of proposed work .S
Describe fully nature of permit requested JFZ
Starting date Approx.time for completion
Call Before You Dig N . Traffic Services Control No.
Show sketch of proposed work or furnish To be fillgd.out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
_
-- Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts t
Final Billing$
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 WILC ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSOR's STREET CUT PERMIT MANUAL.
Signed: /1 a
--� � Date:
,P�&
Title: D.L.#:
PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc