HomeMy WebLinkAboutWater Street Cut Permits Rye and High To r TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3908 Cont;xatf^t"orCdTIVFG:T;..CUT WATER COMPANY
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Location INTERSECTION @ HIGH TOWER ROAIkFs'ddre ;3 25 'DIR ,H "ROAD
Type Work WATER ,` "f
'C�E' EAST YrIN ] 'OR CT 06088
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Dat
e Insp Needed ---------------
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Time Insp Needed77
Inspected By
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Input �� .. Date y'
I Permit No. 3908 Town of South Windsor, CT
Date 03/30/2005 Street Excavation Permit
Expiration Date 03/30/2006
Descrip: REPAIR WATER LEAK>'''PAV':NG $:FL f7 I5'>b' ;DQNE:XBY' y 1
ApplicantI.I1oaton
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Name CONNECTICUT WATER COIj:P T"ERSECTIO ;Q,<'HIGH`TO"ER R
Addr. 25 NORTH ROAD - ROAD
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AST WINDSOR C.T.
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Phone ::..,
(860)292-5552
Applicant agrees 't'orXJ;s the TC7fatfaeh Win3so .the dmaunt of bond
required and to re4rf:b'tlxa t,h:. TQ r 1 s oY�t� ys
3sorc7r and expenses
incurred by the Town.,, 3r ogg � enari'�"'oY>x �ja w�tyrl z .oQqnectxon with this
permit and that app3i:�ant i' fawss7::- C`he rules and
regulations for permits as"outlined �n tie rtw of Sotth:;Wkncsor's Street
Cut Permit Manual.
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* * PERMIT TO.,B �cET 6N.fi7p: SiE AT
PZ TIIS.
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Issued by
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Date Completed ----- Inspected By
APPLICA'ZON FOR STMEET EXcAvATION pERl+!M,T
TOWN OF dUTH WVZ.NQSOR.
PUBLIC WORKS D PARTMENT
TOWN HALL
:�540 SuL ANAVENUE
S®OTh WINDSORf CT
FEE $25.00
Name of f irml cow en7ieev7`" Phone,No
Address,o Fi 2' r 7—de rl
4acaticnc r pfopowo Wpri- �
Describe f my nature of permit reuestod X Ica✓. /an ,g ,a
Starting'd i �?o Apprfloc.time for eofnpletion
Calf Befo You•Dfg No.a0gS1eloO379 Traffic Ser►Ic.-S Control No.D7
Snow sket crf proposed work or fui•rilsh -
�nro Copts of separa► drawlhg To t filled Town of 54�i�Dy Windsor
Indicate N rth Prop•size of cut
No.cuts
/yr r zxr/✓ Amt.of Deposit$ by. - ;• .
Cash Check*.
Cut sizq after Perm. Patch
No. Cufs
Final Bllrng$
Amt. Dub Payee$
Amt. Due Town$
Applicant ii ropppnsipie for rontacting by - date
the Ponce I e t and C.B.Y.b,
r AI$REE FURNISH TO THE'TOWN OFSOUTH WINDSOR THE AMOUNT OF BOLD REQUIRE ANI)•,T0 REIMBURSE THE TOWN Or-
SOUTH WI DSOR FOR ANY E XPI;NSES INCt]PM&)BY THE TOWN FOR MAINTENANCE OR fi PAIR WORK IIV OONN>=GTtON 1NITN THiS'
PERMIT A THAT I AM:FAMILIAR WIT- WAND WILL ASIDE BY THE.ULES ANp RlE�ul�r�on�s,FOR PE�M�TS A5'O.UTLINED IN THl
TOWN OF OUTH WIfVDSOft STREtT BUT PERMIT MAhlUAL
51uned• Date:
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