HomeMy WebLinkAboutTelephone Street Cut Permits Rye Street Permit No. 2415 Town of South Windsor, CT
Date 04/09/1998 Street Excavation Permit
Expiration Date 04/09/ 1999
Descrip : LOOP ELECTRONIC TERMINAL SITE ALL WORK OFF RD
Applicant
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"K 1W 6 Location tie
Name SIROIS & GALE CONST CO-`
Addr. 73 SYLVAN AVENUE
WEST HARTFORD CT 06 �JELEPHONE
Phone (860)521-7077
Applicant agrees t hey _
� � 4 I or the amount of bond
required and to reimb ' W t r f 'r any expenses
incurred by the Town �� n� pas , connection with this
permit and that app 1 i an amp an i i de by the rules and
regulations for permits th Windsor' s Street
Cut Permit Manual .
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* * PERMIT TC) " Sl A�� ,,A L TIMES.
Issued b
Date Completed By
APPLICATION OVFO OF SOUTH EXCAVATION PERMIT
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
5;2�iS �70 77
Name of Firm one No.
Address of Firm ZU1� �, 14 O(r'Icy
Location of proposed work Tel?e ,y91r l i—We4e?-Sl—
Describe fully nature of permit requested P wl t i�- W
Starting date l r/1 6 Approx.time for completion r
Call before you dig no. R L-�'v' l ! Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No. cuts
Amt.of Deposit 8 :559 by
(1 Cash(1 Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee 3
Amt. Due Town 8
Applicant is responsible for contacting
the Police Dept. and C.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO RFJMBURSE 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: n� ��y/ Date:
Title: IV Vj�J- L/ D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES