HomeMy WebLinkAboutTest pits Street Cut Permits Rye Street 700005 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 03/09/07
GIS ID: 78609999
FEE: 2 MUNIS APPLICATION# 20 0700223 5.00
EXPIRATION
RATION DATE:
03/08/08
APP
LICANT
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NAME: FLEX SERVICES LLC : ..::..:.::::::.::::::::.:.:::::::::.:::<:;;:.:>;:
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ADDRESS: 21 WEST DUDLEY T <;, :::...
WN OF<SOUTH WINDSOR
T 0602.;:>;. I54 ;;SULLIVAN AVE
PHONE 860-242-2500 C?UTH WNDSOR,CT 06074
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APPL
ICANT AGREES TO FURNISH THE TOWN O <:: <3IJT€I:. � "<,:;:;;,;:; ">::,;:r,, : ;.»
IOT(5F BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN ';,EPNS INi TT }pQ MA
CONNECTION WITH THIS PERMIT AND THE:<:APPLICAN 1 IS F 1NTENANCE OR REPAIR WORK 1N
A�II�IAI WITH zND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OI' ( i•TH W1NIl.8 y I1 :. TJ�PEg�T' ANUAL.
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ISSUED BY
DAE>IT .PEO'IEI� INSPECTED BY
3/9/20072:52PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: V oono,.-�- CONTRACTOR:
LOCATION: 1I �- LS ADDRESS:
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TYPE OF WORK:_ -E' �C
DATE INSP NEEDED: -310ylol DATE INSP:
INSPECTED BY: 66p
WORK IN
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT ,
TOWN HALL "PP�K"�'"' 'Z�`100�23
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm r �' S `�° p Phone No. 860 — -150 " 2-4Z0
Address of Firm i Ai Wg--& f gJ-1e4 ' r6":,a RO Sloe,, 0100.2
Location of proposed work
Describe fully nature of permit requested K— '- XCa,.act s�? %n P Is to k c- `✓`06,,o z, 1-4,.
Starting date ,<.f Approx.time for completion
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish Indicate North This section to be filled out by
two copies of separate drawing Town of South Windsor
n I Pavement Cut
No.cuts
-------------
Est.Size of Perm. Patch(s)
-------------------
�YJ Est. Pvt.Thickness in.
Est. Unit Price$_________________
Amt.of Deposit$________________
Total Due$---------------
----by
Cash( )Check#----------
A Permanent Patch
No. Cuts
Size of Patch(s)
' -----------------------
�� Final Billing
$----------------------
4"—
Amt. Due Payee
Amt. Due Town
�s
dBy---------------------
Applicant is responsible for contacting 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,A�S/� TLI FIHIN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: `%��'�°� Date: 4lr�
Title: f rid �/' Driver's License#: I't -----
-----------
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
03/23/2007 FRI 11:15 FAX 860 644 7280 South Windsor Town Hall 0001
*********************
*** FAX TX REPORT ***
*********************
TRANSMISSION OK
JOB NO. 3261
DESTINATION ADDRESS 92421493
PSWD/SUBADDRESS
DESTINATION ID
ST. TIME 03/23 11:14
USAGE T 00' 43
PGS. 2
RESULT OK
700005 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 03/09/07
GIS ID:78609999 '0 N '
MUNIS APPLICATION#.200700223 '9.r `°a�. FEE: 25.00•
x E IRATION DATE: 03/08/08
APPLICANT
OCATION
NAME: FLEX SERVICES LLCf
ADDRESS: 21 WEST DUDLEY T "° R O OUTH WINDSOR
r
BLOOMFIELD,CT 06
SQL AN AVE
PHONE 860-242-2500 >`.• r^ : SOR,CT 06074
WORK DESCRIPTION: : 'TEST
FROM �, •�
APPLICANT AGREES TO FURNISH THE WN , O REIMBURSE
TO REQUIRED AND
THE TOWN OF SOUTH WINDSOR FORA E b IN° TO ANCE OR TO WORK IN
CONNECTION WITH THIS PERMIT AND ` IDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN O AL
ISSUED BY D INSPECTED BY
3/9/20072:52PM ***PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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