HomeMy WebLinkAboutWater Street Cut Permits 658 Pleasant Va TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. Contractor M. J . D. CONSTRUCTION CO.
Location Address 26 MONTROSE ST
Type Work WATER HARTFORD CT 06106
......$ one No. (860)953-8025
s 19105
Date Insp Needed p
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Time Insp Needed
Inspected By
Work in Progress
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Date o�b
Perm , Ne. 3458 Town of South Windsor, CT
Date" -04/16/2003 Street Excavation Permit
Expiration Date 04/15/2004
Descrip: PERMANENT PATCH FOR MDC REPAIRS
Applicant Location
Name M.J . D. CONSTRUCTION C `� , EA NT VALLEY
Addr- 126 MONTROSE ST
HARTFORD CT 06106 WATER
Phone (860)953-8025
Applicant agrees t h or the amount of bond
required" and to reim w f r any expenses
incurred by the Town pa ko
� connection with this
permit and that appii a t amp " an ide by the rules and
regulations for permi �jo th Windsor's Street
Cut Permit Manual .
* * PERMIT
L TIMES.
Issued by ���' WA � ^�6
Date Completed spected By
34s0
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm s J U-S�• (-0•
Address of Firm 2 o"t Y§2 - f O Y YeL 060 o 6
Location of proposed work 2 tz I(•P
Describe fully nature of permit requested�a L uQl
V
Starting date Q 2/— 2 2 — n "Z Approx.time for completion
Call Before You Dig No.-2 o o�,16 n1 17 f Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North C r tC Gl Prop. size of cut
No. cuts
Amt. of Deposit$ by
()Cash ()Check#
Cut size after Perm. Patch
No. Cuts
Final Billing $
Amt. Due Payee$
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 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: Date: O
Title• -e ,'& 7 D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc