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HomeMy WebLinkAboutWater Street Cut Permits 432 and 450 Fos 12"EDP TOWN t� A�naIt RCI. X. r• `. wWN."HALL ''t 'on rile 1540'SULLIVAIV IiVENUE ' ' SQUTH WIN MOP 06074 ' Date of Expiration APPL1 N R IT erasit'Expires Name and address of applicant mgrj 1-,097-v4,IPP PboneNo. �y - /79 % y . . � C h►E5 t L�/� . Cdn� Location of,proposed work 5/3Fri Describe ully.nature of permit requested , ­-'&OAA /1v AW v"'1 1 1 _ 'r�rc r Cs ,.!, .v✓, Inst'urance on file with Town yes no ate policy expires_ `9 ; Name of Insurer o Approxialnate time for completion / L✓ k _ IDesired starting diti_t7- q r; Call before ym dig .ticket P1o. 93 /7 t,�7644 '°0 z .; Show sketch, of proposed work or: furnish Z copies of searatie drawing 3, s1. 1•�G ���� N Y6Pj/J r,17- ¢ VAL.V L .- rC 1 %r�t�' //� 0 r:"^ 7711-77, � ?Y yso J" - OSI3A REQUIREMENTS MUST BE FOLLOWED Appliant is responsible for contacting dw-Police Departteent and CALL BEFORE YOU DIG. r j f 1 agree to fnr" to the Town of South Windsor the amount of bond or �f >t reimburse the Torn of South Windsor for any ex deposit required' and to x Penses incurred by the Torn far maintenance or repair work in connection with this pwmit and that, I am familiar with and .wiR abide by regiuiations for permits as outlined in the Town of South 'Windsor's Irist"Cut 6ti*� ., Signed APPROVED: DATE APPRQV D: _ D1�TE ' . Sup'"t. o ighways �"_ Tooaeer -6 :F©li `1 SPirCTOR: ?ate work started _- . Date coma ►leted . ic>lent notr' tcation"received: yes no ype>o repair: Permr. enr, , Unusual conditions encountered P -Material- slips`:attached: yes - "no -- - ate -for Fe- es repair Signed