HomeMy WebLinkAboutDriveway Street Cut Permits 740 Governor Permit No. 2934 Town of South Windsor, CT
Date 03/28I2000 Street Excavation Permit
Expiration Date 03/28/2001
Descrip:
Applicant Location
Name BLUE DIAMOND PAVING INCGOVER.I+IORS HIGHWA
Addr. 1064 EAST ST NORTH
SUFFIELD, CT 06078` � pe.,of,�Wor�c DRIVEWAY
Phone (800)728-4644
Applicant agrees to urrii Sh, the 1 t�1Kn of South Windsor the amount of bond
required and to h Wfndaar. for any expenses
incurred by the Town =fb'r m�',titenanGek ray: "epai r W10rk in connection with this
permit and that appl ic 'rrt :i� ; f 'r andl 1 abide by the rules and
regulations for permits` as o ttl i'ned�� T:Owl � f South Windsor's Street
Cut Permit Manual .
* RMIT T 'E° KEPT ON J, B,: S-ITE AT- ALL
TIMES.
Issued by - Title I ,--2 `
Date Compl t d Inspected By
-. perm",t No. 2934 Date Down of South Windsor, CT
03/:?Sr2000 Street Excavation Permit
Expiration Date 03/28/2001
Descrip:
Applicant Location
Name BLUE DIAMOND PAVING INC 0740 GOVERNORS HIGHWA
Addr. 1064 EAST ST NORTH ;
SUr=FIELD, CT 06078 Type of. Work DRIVEWAY
Phone ;.800 )728-4644
Applicant agrees to furnish 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 applicant is 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 .
r
ERMIT T E KEPT ON JOB SITE AT ALL TIMES.
Issued by Title
Date Comp14 C
�. Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00"
Name of Firm h U, Phone No 0 V
Address of firm
.
Location of proposed work r Y`
Describe fully nature of permit requested
Starting date r� Approx.time for completion ,IS
Call Before You Di No. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two.copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
" 'j1 No.cuts
Amt.of Deposit$ by
33 c,cash Check#
Cut size after Penn. Patch
No. Cuts
Final Billing
Wit.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.
Signed:— - -- -
Date:
Title: JF
D.L.#• �`� `1 (l�p'
PERMIT SHALL BE KEPT ON 306SITE AT ALL TIMES
_ - Standard Forms\Permits\Street Excavation Permit doc