HomeMy WebLinkAboutElectric Street Cut Permits 1140 Pleasan PermitiNo;" . 3057 Town of South Windsor, CT
Date . �. ` 12/i" 1/2000 Street Excavation Permit
Expiration Date 12/ 11 /2001
Descrip :
Applicant Location
Name CL&P ,?"14a P1EASANT VALLEY
Addr. 48 TOLLAND STAGE Rt ��'.
TOLLAND CT 06084 "f pe- 1of Wdirk ELECTRIC
Phone (860)871-3443
Applicant agrees to "f rDi. h tom= T :��f. Qu hWindsor the amount of bond
required and to rein l urns ." TOwi 6f South t�-lridsor for any expenses
incurred by the Town for, i ntet an e . � repro , 6-rk in connection with this
permit and that apt l..a�an I"s,,f .; ' tK-t With s°rid w43 l abide by the rules and
regulations for perms,""s, a ::oc� 1.'rrie�f' _ °h the Ts,wr7 "bf South Windsor' s Street
Cut Permit Manual .
RMI TR' KEPI ;CAI: JOB 'ITE` AT ALL TIMES.
Issued byA',�PET
T i t'l�e z��
Date Comp le ed i Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm_ 2l4 z5 ¢1 ZA, Phone No.
Address of Fi
rm , c�,�N � j
Location of proposed work i o r, T L _ Z,a
Describe fully nature of permit requested
Vcx
s5?T/U�ll
Starting date vo Approx.time for completion i
Call Before You Dig o. ZDOOS�Oo p$ Traffic Services Control No.
Show sketch of proposed work or furnish To be filled o t by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut
"mil/�l0 No.cuts
Amt.of Deposit$ by
O Cash O Check#
5i4NF.
Cut size after Perm. Patch
Q No. Cuts
(� Final Billing$
y 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: v
Date:
Title:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc