HomeMy WebLinkAboutMiscellaneous Street Cut Permits 51 Ridg TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. C 2687 Contractor JMJ CONSTRUCTION CO.
Location 0051 RIDGE ROAD Address 658 ELLINGTON ROAD
Type Work MISCELLAN SOUTH WINDSOR CT 06074
Ph6ne. No. (860)528-7889
Date Insp Needed °
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Time Insp Needed -Tl M0l,,I',,,pp A5 N:T__o
Inspected ByQ
Work in Progress
Input " _ Date
Permit No. 2687 Town of South Windsor, CT
DAtd 05/14/1999 Street Excavation Permit
Expiration Date 05/13/2000
Descrip: WATER SERVICE-NO PAVEMENT CUT
Applicant Location
Name JMJ CONSTRUCTION CO Q051 'RDG� ROAD
Addr . 658ELLINGTON ROAD J
SOUTH WINDSOR CT 0(ro 7 or ,MISCELLAN
Phone (860)528-7889 -
Applicant agrees to fU th+ Wlj.�or the amount of bond
required and to re�mtyu � ov�n r fr any expenses
incurred by the Town frrtenp 'epa %rlei connection with this
permit and that applirani iam 1 andA abide b the rules and
regulations for y permits 'a ,Kta �G� I "tit�dTo�cbfoth Windsor ' s Street
Cut Permit Manual .
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43
* * PE MIT r $ �C: ' At'"� L TIMES.
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Issued by _..G- Tiierl •- dr -�G
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Date Completed J� z inspected
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APPLICATION FOR STREET EXCAVATION PERMIT $?
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $2S.00
Name of Firm .J �jfiJ S
Address of Firm Phone No.
Location of proposed work >
Describe fully nature of permit requested
Starting date
Call Before You Dig No. Approx.time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing To be filled out 6v T wn of South Windsor
Indicate North
Prop.size of cut
No.cuts
Amt.of Deposit$ by
{)Cash OCheck#
Pv61 ,s Cut size after Perm. Patch
1 .
i No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due.Town$
Applicant is responsible for contacting l
the Police Dent and C.o.Y.D, by date
I AGREE To FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CON
REIMBURSE THE TOWN OF
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE RY THE RULES AND REGULATIONS FOR PERMITS AS OUT
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. NECTION WITH THIS
LINED IN THE
Signed• _
&4,
Date:
Title:
D.L.#.
PERMIT SHALL BE KEPT ON 308SITE AT ALL TIMES
Standard Forms\PermitAStreet Excavation Permit.doc