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HomeMy WebLinkAboutWater Street Cut Permits 165 Pine Tree L TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3897 Location 0165 PINE TREE LANE Cone, a..ct�yr COVED'::-CONSTRUCTION CO. Type Work WATER Addr P O ^BOX 4" ,a COVEN7RYT 0638 hoe, No f86Q�,�:8.2 0526:;;. Date Insp Needed —_� /2�1� Time Insp Needed _ rt � Inspected By — e Work in Progress lie 77 y Input .,. Date Permit No. 3897 Town of South Windsor, CT Date 01/20/2005 Street Excavation Permit Expiration Date 01/20/2006 Descrip: PAVEMENT PATCH FEE' TBD ::. Applicant S?:Locat.i'on XXXX Name COVEN CONSTRUCTSON 60,, 165,,PINE TREE L1LJE Addr. P.O. BOX 427 COVENTRY CT 06 38 T pe 01 or: X. iq�Y $12 Phone (860)282-0526 Applicant agreed to furnia the ,TaWri f ;South Windsor tho-.amount of bond required and to reimburs : the",Towazf Sa�1 }s �7zcs;or for any 'expenses incurred by the Town fr 'lnagint ;nance or re air wox 1iionn .Gton with this P permit and that applacant js fa:tnz]ia With ;ait� 'vial} abide, by :he rules and regulations for permits as outaned £n tha sTown ,of Br�uth VTancsor's Street Cut Permit Manual. * * PERMIT TO`'BE IEPP ON'"(TOB' SI'PE AT ,AFL;, Ix, IES. 7 � Issued by G%� Title G - -Y -- - Date Completed - ........_-- Inspected By APPLICATION FOR STREET EXCAVATION PERMITS p� TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $25.00 -Name of Firm - ti> �!L Phone No. ` O Address of Firmit b /ti Location of proposed work j 116 _p, F i A o ✓,j.�,r '' 2 tJ,L�L Describe fully nature of permit requested Starting date or completionCali Before You Dig o. ��Tt�fflocx��ers Control No. Show sketch of proposed work or fu ish two copies of separate drawing Indicate North This section to be filled out by Town of South Windsor Pavement Cut No.cuts Est Size'9f Perm.Patch(s) Est.Pvt.Thickness In. Est..Unit Price$ S ,fit G U Amt of Deposit$ Z o Total Due$ av by ( )Cash( )Check# Permanent Patch IQ ---- ��) No. Cuts Size of Patch(s) �1 �"--� Final Billing �)- Amt.Due Payee $ fc Amt.Due Town By -:7 Applicant is responsible for contacting Date the Police De t.and C.B.Y. �fi I AGREE TO FURNISH T THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF.SOUTH WI D OR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION ITH T I PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS A IN I L TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MA UAL. 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