Loading...
HomeMy WebLinkAboutWater Street Cut Permits Norman Drive q TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3545 Cont;ra>c't"or V f90M;,.00NSTRUCTION LLC Location NORMAN DRIVE Addres:S 138"RYE. STTk°E.$T Type Work WATER SOUTH W<INASOR 'C:T 06074 Phone 52$-8928 Date Insp Needed _------ "Date znsp � � Time Insp Needed ---------- „>. Dime 1' !< ?� — "�— Inspected By ,� r Q' a Work in Progress cK f✓ErG�ca �, pyl u , � ✓- ---- --- .1 Xi. Hc�G Pet ved Permit No. 3545 Town of South Windsor, CT Date 07/16/2003 Street Excavation Permit Expiration Date 07/15/2004 Descrip: WATERMAIN REPLACEMENT AND ;RdAI1 RSAZRS""' Applicant Lcc .Cavn Name FOLSOM CONSTRUCTION LLC'„ A7flRIvAN DRIVE Addr. 138 RYE STREET SOUTH WINDSOR CT 450 74. Type of F7ork :t7Am$k� 5 Phone (860)528-8928 .. Applicant agrees to the„Town st kSahth Windsor''t;he . mqunt of bond required and to reimburse ,that Totrn,;zsf Southtxdsiax for any 'eaepenses incurred by the Town fbt [na ,#fti�nance or repair` word zn bcxnnectzon with this permit and that applicant iS`," anvil ar xt r .wi11 "4bide by the rules and regulations for permi`�s ap ol�t fined x Elie 1G'A cif S7uth,43:1ndsor's Street Cut Permit Manual. * * PERMIT TO BE IQEPT.ON JOB SITE AT ,ALL>; TTMES. Issued by Date Completed -— Inspected By - ._---- APPLICATI ON FOR STREE T EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm _ - c l S urn ,„ a � f b Phone No._ ��[' S 2 Address of Firm P - _ `:, .�- ',',� .✓ . 7 �7' r� -� Location of proposed work g H ,-,,, Describe fully nature of permit requested 4e,,,,,d Starting date 7 i 7 t? Approx.time for completion Call Before You Dig No._`2.002 Z go-1 3,3 Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate drawing Pavement Cut Indicate North Prop,size of cut j., f✓� e No.Cuts le vv. -j� ou�n v>u�� Amt.of Deposit$ by �e c��u✓ O Cash O Check# Cut size after Penn. Patch No. Cuts Final Billing$ Amt. Due Payee$ Amt. Due Town$ Applicant is responsible for contacting by date the Police De 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: !S © 3 Tide: t a; c /L'ju 4 v,- PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc