HomeMy WebLinkAboutReplace hydrant Street Cut Permits Pleas PERMIT
NUMBER TOWN OF SOUTH WINDSOR, CT
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STREET CUT PERMIT
DATE: 10/02/07
GIS ID:47709999
MUNI S APPLIC
ATION
AT I ON 200
701592 0 70 1 592 FE
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IRATI0N DATE:
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NAME: METROPOLITAN DI T �,ADRESS• 125MAXIMRO T�
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!x-1-540 SULLIVAN AVE
HARTFORD H WINDSOR
P H
O W-ND NE s.. S
C T.. 06 74
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SCRIPTION:C RIP TI O N:
RE PT ACE :
t�R" 'Li* SANTVLY,ON J FITCH BLVD
APPLICANT AGREES TO F
URNISH THE 1`°:�3�T.�F'`��UT'L—T; ,•,4:.'.:, .;. .,, ... •.'
` Y�, �iE AMfJT BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AlIz ENS ;1`T !:. ` F�' ,MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE`�PPLIANT"IS`: '..
FOR PERMITS AS OUTLINED IN THE TOWN OF SflTTI 'VVT1D T MIUAL Y THE RULES AND REGULATIONS
ISSUED BY ;:<w�,=`t:.•': � ..::,�<r� ::>:�::r,.<.:rr'•
DATE INSPECTED INSPECTED BY
10/2/200710:46AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 7d/.S 7 CONTRACTOR:_ 1�I
LOCATION: Kil)f rwr
TYPE OF WORK: t
DATE INSP NEEDED: DATE INSP:__ L//,Cog
INSPECTED BY:- din
WORK IN
PROGRESS:—
AS-BUILT:
INPUT:_ DATE:--
W/2007 Town of South Windsor INPSECTION REPORT 07
SEP. 28. 2007" 8: 51AMr"" °MDC SYSTEMS REPAIR'___v yv " NO. 007 P. 3
APPLICATION FOR STREET EXCAVATION.PERMIT
a TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
" -Name of FirmNo.
Address of Firm - Ct t (�-� �-�- -Z - 0 900
Location of proposed work._
Describe fully nature of permit requested
Starting date I 0 1 —C7'7 Approx,time for complefio
Call Before You Dig No, 204'1 . p Q TrafFc Services Conts`aI Na.
Show sketch of proposed work or iumish
two copies of separate drawbg Indicate North- Rl section to be filled orrt by
Tom of s!21gb Nindsnr
Pgavernent.Cut
e
No.cuts
pCEstSize of Penn.Patch(s)
EsL Pvt Thickness
Est Unit Price$
AmL of Deposit$
Total Due$ by
Permanent:Patch
No, Cats
Size of Patoh(s)
Final Brilfrng
4-. - AmL Due Payee
p� AmL Due Town
Q)
APPlicant is res orislbte far aontactin _
the Police Dept ana C.B.Y.D. Nato
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 LENSES INCURRED BY THE TOWN FOR MAJIMNANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMITAND THAT I AM FAMILIAR WITH AND WILL ABIDI=BY THE RULES AND REGULATIONS FOR
PERMrrS AS OUTLINED IN THE TOW OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL,
Signed,
oat•. C ~ l_-•0`1
7710e1 Sc,P
qL:aLr-VjDriver's License#_
PERMIT SKALL BE KEPT ON JOBSITE ATALL TIMES