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HomeMy WebLinkAboutSanitary Main Street Cut Permits Nevers Town of Soutn Windsor , CT 60 Permit No, 2 Str-eet Excavation Permit Date 00/SO/1997 { Expiration Date 09/30/ 1998 ' O g ,76 IS FOR PERMIT ) Descrip: INSTALL DOGHOUSE %ANFfOLE OVER EXIST . MAIN LOCati7r Applicant Name INCORPORATED CONSTRUGTION NEVER.S `kD, :4T COLLINS CROSSING Addr . 12 NORTHWOOD DRIVE Type o�f Wc�r► SAN MAIN BLOOMFIELD CT 06002 Phone (860;242-0150 i; Applicant cant agrees to furnish the Town o 5oi+th Windsor r r e 'for foranyexpenses required and to reimburse the Town Of oU" Warydsor incurred by the Town for ma7ntenance :or ^epair wort, �n this enrules and permit and that applicant is fam7'liar with and will abide by regulations for permits as ©Utlined in the Town Pf -South Windsor ' s Street out Permit Manual . a* s" PERMIT T( BE KEPT-ON JOB, • OB, SITE AT ALL TIMES . Title ? ----- Issued by � 9_ j Inspected By -- Gate Comp 1 etei _ _- vJJ APPLICATION FOR STREET EXCAVATION PERMIT . TOWk/0' SOUTH WINDSOR PUBLIC T�WN DEPARTMENT 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm h a/.' c�Yk�' mot.S p�. i, �-T�Y Phone No. 2-42 c�l,X 0 Address of Firm % Location of proposed work L�l/P�s ���s s i �wC✓S �`� Describe fully nature of permit requested !/ Starting date Approx.time for completion Call before you dig no. �f 7 Z 7v2 / ,�( Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of So. Windsor two copies of separate drawing Pavement Cut Indicate North Prop.size of cut$ 1,0 X/d Z 7-0T' No.cuts Amt.of Deposit $ `34 vjy � O Cash O Check# Cut size after Perm. Patch No.Cuts Final Billing $ rr Amt. Due Payee $ �C-� � vbe�JCJ:�Jc:,e, oyS 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: e 2 ETtf Title: D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES