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HomeMy WebLinkAboutWater Street Cut Permits 112 Pheasant Wa (2) Town of South Windsor, CT Permit kb- 2237 Street Excavation Permit Date 08/30/1996 z_ Expiration ;Date 08/30/ 1997 Descrip: Location Applicant Name INCORPORATED CONSTRtlCTI©N 1f2P ' EASANT" WAY Addr . 12 NORTNWOOD DRIVE Type° of "Wars, WATER BLOOMEIELD CT 06002 Phone (860)242-0150 � Applicant agrees tO ,furn - -f6r any ash the, ToW.i`1 p ''$ptath `W�ndsor the amountbond required and to reimburse thnenancef d �QPa rWG�a connection rules andth incurred by the Town for M� permit and that applicant, �e fBAIAti4r,"w1"���� and W " 11' .'ap�ide Y regulations for perm i is " s ci i ned 7 ' the Taws cif. South Windsor' s Street Cut Permit Manual . PERMIT, T B1~."'KEPT ON JEB SIDE."A"t ,ALL T I M PES. * ,.f Issued by Date Comp l ed Inspected BY Y .:, i.7r,. ,.K:o.,..�,Pxcat-�a•� .yl�"YfP'sr� .;:N. y,., ..--+s'-,r;i - .+�.wir.-.w•mR"a.^r,....,�,�,.rEges'zsev.�+�-.:,....R�.e;;vT :u= .r - .7� c� APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR Amt. Bond Required ^^ PUBLIC WORKS DEPARTMENT — � , Amt. on File .�•►' TOWN HALL Permit Date of Expiration 1540 SULLIVAN AVENUE Date__ Ins. on File es O No SOUTH WINDSOR, CST Permit Expires Expiration Date q l'S0/4 FEE $25.00 --------------- Name of Firm `'_ 4Z,v ; t e/f Address of Firm /Z LIC-1- �_•� awl %fir ��'!>� ,��1 '- Phone No. Location of proposed work Describe fully nature of permit requested -?' s Ar•f% .pti Starting date Approx. time for completion Call before you dig No. 9 6 3 Sv 7 O 3 0 Traffic Services Control No. Show sketch of proposed work or furnish To be Bled out by Town of South Windsor two copies of separate drawing Pavement Cut O Indicate North Prop. size of cut No. cuts Amt. of Deposit $ 0' b4� O Cash O Check #— Cut size after Perm Patch - -- No. Cuts Final Billing $ Amt. Due Payee $ Amt. Due Town $ ._ Applicant is responsible for contacting the Police Dept. and C.B.Y.D. by date I agree to funish 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 xill by IiArules and regulations for permits as outlined in the Town of South Windsor's Street Cut Permit Manual. Cel!'e �/ Signed: Title: 11291c- D:LL.# Zia 0G 7 Date: bf PERMfT SWILL BE JOBSITE AT TIMES APPROVED: DATE:( ) " l TOWN EIMR , FOR INSPECTOR: Date work started Date Completed Signed Date WHITE - PERMIT PINK- ST. SERVICES YELLOW ENGINEERING "'"'^'" GOLDENROD FINANCE