HomeMy WebLinkAboutWater Street Cut Permits 60 Oak Street i
Permit No. 3046 Town of South Windsor, CT
Date 11/07/2000
,0 Street Excavation Permit
Expiration Date 11/07/2001
Descrip:
Applicant Location
Name CONNECTICUT WATER COMPANY
OfJ60 °'QAK STREET
Addr. 2-5-NORTH ROAD �^
EAST WTNDSOR CT 060$8 pe pn WATER
Phone (860 )292-5552
Applicant agrees to urn .5h 'thr� w ' :of St}i Windsor the amount of bond
required and tomtsur' e Town °d Sc�uth ,Ws n .py for any expenses
i n c u r r e d by the Town fc�r ► ten n�Q ' repat Work;'i n connection with this
permit and that app l fca-ot ' fam i 1 ar ,'-h aril w i,-7,1 abide by the rules and
regulations for permit .as Out T .rr�f.
Cut Permit Manual . South Windsor's Street
.
* 7ERMIT ' . BE KEf�T 4I :Jt?$ ,SITS AT ALL TIMES.
Issued by _ Titi.e -
Date Complete
/ ,Inspected 8y
` APPLICATION FOR STREET EXCAVATION PERMI
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
IiIJ
SOUTH WINDSORF CT
FEE $25.00
Name of Firm -
Phone No. loac3 335��eopt. c3c3�p"�
Address of Firm
Location of proposed work
Desert f II n ture of requested
Starting date _ - Approx.time for completion
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be f lied'out by Town of'South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
1 No.cuts
Amt.of Deposit$ by
{}Cash{)Check#
Cut size after Perm. Patch
No. Cuts
Final Billing
Ot Amt. Due-Payee's
Amt. Due Town$
Applicant is responsible for contacting by date
the Police Dept.and C.B.Y.D.:
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND T0-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:-- A— Date:
Title:dw A �� D.L.#:
PERMIT SHALL BE KEPT ON 7OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc