HomeMy WebLinkAboutStorm Street Cut Permits Niederwerfer at Permit hJ -. 2 2,3 3 i own of South Windsor, C:T
Date 10/23/ 1996 Street Excavation Permit
Expiration Date 10/23/ 1991
Descrip: STORM CROSSING AS OART OF CHASE FARMS SUBDIVISION
Applicant Location
Name PAUL L. SZEWCZYK EXCAVATOR NI,EDtRWERFER AT CHASE FARMS RD
Addr. 490 COLEMAN ROAD
MIDDLETOWN OT 06457 Type of work STORM
Phone (860) _
Applicant agrees to f urn i sh 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 app i i carat i s' familiar with and will abide by the rules .and
regulations for permits as outlined i;n the Town ot South Windsor's Street
Cut Permit Manual .
?� 4' PERMIT T,Q /,8E KEPT ON JOb SITE AT ALL TIMES . �
T i t l e
Issued by r' _ y #t
Date Comp l e;te� _ `)� __._____.._ Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
" PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00 _
Name of Firm Paul Szewczyk Rxcavating, Tne_ Phone No. (860)347-8502
Address of Firm 490 Coleman Road, Middiptown, CT 06457q
Location of proposed work Ni dPrwPrf mr Road C3)
Describe fully nature of permit requested Tnstall 30" RrPpi=p and flarpil end into new cateb basin on
Niederwerfer Rd ad. Work being performpd is Hart of snhtlivi.cinn re=nirpd for rhasp Farms Sub-
Starting date October 21,_ 1996 _ Approx.time for completion 1 week division.
Call before you dig no._, 964201 286 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town-of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut x 25'
/ /Xew Ca-lc�t �®sib
No.cuts_ Q �
14 as /1.02 Amt.of Deposit$ CJ' / ��''I (��
So F3>u� �
Cash O Check# ---
Cut size after Perm. Patch pO 007—
0 No.Cuts
Final Billing $
0 Fl-Ied e�,�. -
Amt. Due Payee $
Amt. Due Town$
Applicant is responsible for contacting
the Police Dept.and C.B.r.D. by slate
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: J J / f�
Title: 41(' D.L.#f D®MI7 00�
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES