HomeMy WebLinkAboutWater Street Cut Permits 476 Graham Road ?own of South Windsor , CT
Permit No. 2248
Date f 10/17/'i996 �" ._ S°t-ree,t Excavation Permit
Expiration Date 10/ 17/ 1997
Descrip:
Applicant Location
Name STATE LINE SEWER & CONST CO 047E GRAHAM ROAD
Addr. 238 SHAKER ROAD 1-y 11pe of Work WATER
ENFIELD CT 06082
Phone (860)749-6176
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 i connection with this
'n
permit and that applicant is, famiiiar w and
ith and will abide by the rules
regulations for permits, as outli>ned in the Town of South Windsor' s Street
Cut Permit Manual .
PERMIT T"O BE KEPT ON JOB, SITE AT ALL TIMES. �
_ �y
Issued by �. -' �- - � ► i t 1 G
Date Comp 1 e ed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm v�`4 (L" �Z awe o.
Address of Firm P .T 4 n L/ G T�
Location of proposed work I,/74r Gl a 0.01.11
Describe fully nature of permit requested .e / " oll, rs /f e,
.c�tiar�2�rv' Jae -K,
Starting date b c Approx.time for completion i 9
Call before you dig no. jF G `//d S1<3 Traffic Services Control No.
Show sketch of proposed work or furnish / To be filled out by Town of So. Windsor
two copies of separate drawing _/ Pavement Cut
Indicate North Prop.size of out
No.cuts
Amt.of Deposit$ by
(►Cash()Check#
e Cut size after Perm. Patch
No.Cuts
J�l�Crrt,tr[ �✓'a t Final Billing $
Amt. Due Payee $
Amt.Due Town$
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. by date
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: y ' ��S�G�J•�r� D.L.ff 1 7-?/ 7 �/S
PERMIT SHALL BE KEPT ON J08SITE AT ALL TIMES