HomeMy WebLinkAboutDriveway Street Cut Permits 90 Skyline D Permit No. 2787 Town of South Windsor, CT
Date 07/30/1999 Street Excavation Permit
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Expiration Date 07/29/2000
Descrip:
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Applicant Location
Name E.C. PAVING ,'00`50. SkYLhNE DRIVE
Addr. 139 WETHERELL ST
MANGHESTER CT 0604Trpe ,of Weak DRIVEWAY
Phone (860)647-9834
Applicant agrees to- furh s the.:'Tawn cif SoutW"Windsor the amount of bond
required and to reimburse tFre own. of South Windsor for any expenses
incurred by the Town ,folr maapit natice or;,repair work in connection with this
permit and that appl i;c t i ., f. 71 ` -r with ante veil i_ wide by the rules and
regulations for permits as� but 1 e€�. in, �t .�: Town ,of � South Windsor' s Street
Cut Permit Manual .
* * PERMIT TA BE, KEPT, ON JflB` SITE AT ALL TIMES.
Issued by Title _
Date Complet d ` Inspected S
p Y _
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT '
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm
Address of Firm Phone NO.--
Location of proposed work
Describe fully nature of permit requested
Starting date
Call Before You Dig No. Approx.time for completion l
Traffic—Services-control No.
Show sketch of proposed work or furnish
two copies of separate drawing To�e filled out by Town of�+uth Windsor
J n Q&
Indicate North 4,� �s Pave me.�
-----�. �
Prop.size of cut
No.cuts
Amt.of Deposit$
by .J
{)Cash O Check#
Cut size after Perm. Patch
36"X No. Cuts
Final Billing
Amt.Due Payee$
A � Amt. Due Town$
Applicant is responsible far-ritacting 6y the Police De t.and C.B.Y.D. dame
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT O SOUTH WINDSOR FOR F BOND REQUIRED AND TO REIMBURSE THE TOWN OF
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:' v C
® Date•
Title:
D.L.#!
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc