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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2879 Contractor COVEN CONSTRUCTION CO.
Location 0286 FOSTER ROAD Address P.O. BOX 427
Type Work NEW SAN LAT COVENTRY CT 06238
Phone No. (860)282-0526
Date I nsp Needed �%' —= Date I nsp. /oJZC�9
Time Insp Needed �iL/�'s "trine Insp�
Inspected By
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Pe-,-rhfti 4No 2879 Town of South Windsor, CT
Date 10/12/1999 Street Excavation Permit
Expiration Date;,W/11/2000
Descrip:
Applicant Location
Name COVEN CONSTRUCTION CO. 0286 FOSTER ROAD
Addr. P.O. SOX 427
COVENTRY CT 06238 Type of Wo rk NEW SAN LAt
Phone ( 860 )282-052fi
Applicant agrees to; furri 5t, he Tawny of South Windsor the amount of bond
required and to reimburse. thejown of South Windsor ,for any expenses
incurred by the Town for 'rmaintenance or repair work in connection with this
permit and that applicant as familiiar with and will abide by the rules and
regulations for permits as OUtlined in the Tow
Cut Permit Manual . n of South Windsor 's Street
PERMIT TO BE KEPT' ON J08 SITE AT ALL TIMES .
Issued by w,
Title s. �,'
Date Completed --ZeA�Ip „� Inspected By — �
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Phone No. b� 7 0� �7�o Y b
Address of Firm O 13 aA,
Location of proposed work
Describe fully nature of permit requested c
Starting date Approx.time for completion
Call Before You Dig No. 3 Traffic Services Control No.
Show sketch of proposed work or furnish
To be filled_out by Town of Sout_ r
two copies of separate drawing
-
PM&MMt Cut
Indicate North Prop.size of cutX
No.cuts i
Amt..of Deposit 2S by ?S
' O Cash Wr heck#
✓� Cut size after Perm. Patch
1 No. Cuts
Final Billing$
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 FA R WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSO BEET CUT PERMIT MANUAL. -
Signed: Date: K
Title: D.L.#:
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc