HomeMy WebLinkAboutExcavation for water main Street Cut Per N2 621
BOND TOWN OF SOUTH WINDSOR
Am't Req. PUBLIC WORKS DEPARTMENT Date
TOWN HALL
Am't on Fil+e..\ 1540 SULLIVAN AVENUE Permit No.
SOUTH WINDSOR, CT 06074
Date of Expiration Permit Expires
APPLICATION FOR PERMIT
FEE $10.00
Name and addre s s of applicant 'Tc"ti r,? Cor j) Phone No
Location of proposed work
Describe fully nature of permit requested
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Insurance on file with Town yes no Date policy expires P—9 - C
Name of Insurer L i V, ,,A \1 u u l
o Approximate time for completion 3C) c, , Desired starting dateQ, TIED
Call before you dig ticket 110. Q 3 9 1
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Show sketch of proposed work or furnish 2 copies of separate drawings
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04 Applicant is responsible for contacting the Police Department and CALL BEFORE YOU DIG.
I agree to furnish to the Town of South Windsor the amount of bond or deposit 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 Windsor's (Pavement Cut/rgegulations.
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Signed 1 t
APPROVED: DATE APPROVED:/ DATE !z
Supt. of Highways �To n' Erg er
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FOR INSPECTOR: Date work started % Date completed
Sufficient notification received: yes no Type of repair: Perm. Temp.
Unusual conditions encountered
Material slips attached: yes no Dated for Permanent repair
Signed
Inspector
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VALVE CUT-IN NORTH
%SCOTT DR. SOUTH WINDSOR
_•1_. /
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I BREEZY HILL RD. 500
GRADIENT
Qr' PRV PIT
l PoD�
�• a0 DR•
REDUCED GRADIENT
VALVE PLAN
NTS
x - DENOTES VALVE TO BE CLOSED
WORK TO BE DONE BY CWC.
" -- -- - EXISTING r WATER MAIN
—'"— - EXtSTINC 12- WATER MAIN
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