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HomeMy WebLinkAboutSanitary Lateral Street Cut Permits 360 TOWN_ OF SOUTH WINDSOR INSPECTION REP Permit No. 2896 Contractor INCORPORATED CONSTRUCTION Location 360 SLATER STREET Address 12 NORTHWOOD DRIVE Type Work NEW SAN LAT BLOOMFIELD CT 06002 Phone No. (860)242-0150 Date Insp Needed ; Date Insp. 1Z�(s��fj Time Insp Needed Ins p=' Inspected By ;. w�o Work in Progress � w�R �q'T (., ,,✓ a con�n��f¢ v Kr�i Kac�Cfi�d�� /N-J„5 o " Input -4Date lzl-7/h Pe w**y-• No. ?896 Town of Sough Windsor . CT Lute 12/02/1999 Street Excavation Permit Expiration Gate 1210 112000 Descrip : PERMIT FEE PAID CASH Applicant Location Name INCORPORATED CONSTRUCTION 360 SLATER STREET Addr . 12 NORTHWOOD DRIVE BLOOMFIELD CT 06002 Type of W6rk' NEW SAN LAT Phone f860j242-0150 Applicant agrees to furnish" the Town of South' W7n'dsor the amount cf bond required and to reimburse "the.- Town of South Windsor for, any expenses incurred by the 'Town for msain'tenance or, repair work in connection with this permit and that applicant l�s ''fam; liar with and wIill ab1ce by the rules and regulations for perms is as, outl ne,d in the Town of South Windsor 's Streoi; Cut Permit Manual . PERMIT TO 8'E. KEPT 'O JOB-, SITE AT; ALL TIMES. � M Is-sued by -- - -- -- �_ Tr t le - Date Comp ieteci Inspected B APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSORF CT FEE $2500 Name of Firmhc > ��"r09 Phone No Z G Address of Firm 2 tom„ „ /-ro zfe Location of proposed work Describe fully nature of pe nit requested 14 v�� � r r- Starting date Nd C Approx.time for completion 2 s� Call Before You Dig N . /gyp yP©2sS9 --Y Traffic Services Control No.. Show sketch of proposed work or furnish To be f l _ out by Town of South Winder two copies of separate drawing Pavement C�� Indicate North , Prop.size of cuts 6 f 54 A-TucN p No.Cuts f Amt.of Deposit$ 7!E!R,4-o by' y O Cash 4check# M6 t Cut size after Penn. Patch f No. Cuts Final Billing$ Amt. Due Payee$ Amt. Due Town Applicant is responsible for contacting by " the Police Dept. and C.B.Y.D. date 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 WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: lee Title: D.L.#: PERMIT SHALL BE KEPT ON 306SITE AT ALL TIMES Standard FormsTermitAStreet Excavation Permit.doc