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HomeMy WebLinkAboutWater Street Cut Permits 43 Sally Drive Town of South Windsor , CT Permit No. 3005 Street. Excavation Permit Date 08./02/2000 Expiration Date 08/02/2U01 w Descrip: MDC PATCH _;:� . Location Applicant 0O43 SALLY DRIVE Name M.J .D.MONTROSE ST CONSTRUCTION GO. Addr . 26 Type of Work WATER HARTFORD CT 06106 Phone (860 )953-8025 ish the Town of South Windsor the eamensesof bond Applicant agrees to Earn for any P required and to reimburse 'the Town of South it ork in o by the rules and incurred bY the Town for maintenance or repair W�11 abideconnection with this permit and that applicant is familiar with an permits as outlined in the Town of South Windsor' s Street regulations for P Cut Permit Manual . * * PERMIT TO BE KEPT ON JOa SITE AT ALL TIMES. T i t 1 a -- '- Issued by Inspected BY Date Completed --- 300fr APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH *INDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSORF CT FEE $25.00 Name of Firm ® K Phqne No.00o_ qr 3-,�'o 7 r Address of Firm c t o r D Location of proposed work Z/ Describe fully nature of permit requested Starting date_19 P- 0 7- ©© Approx.time for completion Call Before You Dig No. 2m� 3?0 M6 A Traffic.Services Control No. Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate drawing Pavement Cut Indicate North Prop.size of cut No.cuts Amt.of Deposit$ by O Cash O Check# Cut size after Perm. Patch No. Cuts Final Billing$ -Amt Due Pays@ Amt. Due Town$ Applicant is responsible for contacting by date the Police De t.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 WINDSORIS STREET CUT PERMIT MANUAL. Signed: Date: R-',o L—0 o Title: m PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc