HomeMy WebLinkAboutWater Street Cut Permits 33 Norman Drive Permit. No. 2272 Town of South Windsor, CT
Date 01/21 % 1997 Street Excavation Permit
Expiration Date 01 /21 / 1998
Descrip : WADER MAIN BREAK IN NEED OR REPAIR .
App I i cant.. L oca-t.i on
Name CONNECTICU T WATER COMPANY � Ut�:�3 NURMAN DRIVE
Addr . 25 NORTH ROAD
EAST" �JINDSOR CT O�tJ8$., "gyp p# ,. ork DATER
Phone (860 )2,92-5552
Applicant agrees to fur,ni'sh the T.owh of Soi)t,1, : Windsor the amount of bond
required and to reimburse the",'Towh 6f South wirctsar for any expenses
incurred by the Town for,, maintenance; o repair wdr'k"j , connection with this
permit and that applicant famii:iar with' ana ',w711 abide by the ru1es and
regulations for permits as vutj i necl i n the TQWn 11 of South Windsor ' s Street
Cut Permit Manual .
* PERMIT TO BE KEPT ON 46B 'SITE AT ALL TIMES. * .�
Issued by1✓ title ,. 4 { ','; r1� .__
---- -- --- -W- -- _ — �. —
Date Comp feted Inspected 1i e L n
y
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
Name of Firm V Phone No. ,2?4, J-5 e
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date - Approx.time for completion
Call before you dig no. Q Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town Of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North � Prop.size of cut�33
' No.cuts
Amt.of Deposit$ by
(1 Cash O Check#
ICut size after Perm. Patch
No.Cuts
Final Billing $
j�. Amt.Due Payee $
Amt.Due Town $
Applicant is responsible for contacting
the Police Dept.and C.S.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: L/ ��lLl (/[G Date: /-aj-9�
Title: ZZ&ZLtj id D.L.#
PERMIT SHALL BE KEPT ON J013SITE AT ALL TIMES