HomeMy WebLinkAboutDriveway Street Cut Permits 342 Slater S Permit No. 3094 Town of South Windsor, CT
Date 04/23/2001 � Street Excavation Permit
Expiration Date 04/23/2002
Descrip:
Applicant Location
Name COLONIAL PAVING n' >
Addr. 244 LOMBARDO DR
E. HARTFORD CT 06 18 Type �f4+fre DRIVEWAY
Phone (860)568-9613
Appl icant agrees 10 #L;1)- � the ; y af_ S-66th ,Windsor the amount of bond
required and to reimk urse�ttle, Town of ' OUth W i,h,tlsor for any expenses
incurred by the Town fobpa i r �ti�rrk i connection with this
permit and that applicant ' to :"Fam �'i ai^' w th' ,pair
.: rid wl 1 T` abide by the rules and
regulations for permits as .w�� 1T t i.n<, t ,T , of"ZOuth Windsor's Street
Cut Permit Manual .
* PERMIT BE KEPT ON °:JOB SITE AT ALL TIMES.
Issued by
t` Ti't1e -)It, —
Date Compl to Inspected By
CI
APPLICATION FOR STREET EXCAVATION PER
TOWN OF SOUTH WINDSOR MIT
PUBLIC WORKS DEPARTMENT
TOWN HALL 3, 0q
1540 SULLIVAN AVENUE
SOUTH WINDSOk CT
FEE $25.00
Name of Firm e4LO
Address of Firm Z Lo C' ' NNPhone No.
Location of proposed work d 7
s� Te R a
Describe fully nature of permit requested SOS o
-------------
�' VE
Starting date A. p/
Call Before You Dig No. oO j/sO0 a 8 Approx.time for completion A AX
Traffic Services Control No. E�
Show sketch of proposed work or furnish
two copies of separate drawing To be filled put b Town of South Win- dsor
India --i___ Pavement ut
--- _ — -- -------—---- _ - Prop. size of cut
No.cuts
-- — -- __
- - ------_.— �__ Amt.of Deposit$
-- -----_--- --�._.._______----�— by
Cash O Check#
--- - ____ ___-- --- ------�-- Cut size after Perm. Patch
-- -- - - ---------------------- - No. Cuts
-- c-- - ---- -- _`__ Final Billing$
- Amt. Due Payee$
-- - — Amt. Due Town$
Applicant is responsible for contacting 1` f
the Police�t_and C.B.Y_D. by
date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR AMOUNT
OFN
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGU(AnO ED AND TO REIMBURSE THE TOWN OF
MAINTENANCE OR REPAIR WORK IN CONNECTION WITHTHIS
TOWN OF SOUTH WINDSO STR NS FOR PERMITS AS OUTLINED IN THE
CUT P RMIT MANUAL.
/I
Signed: n
Title: Date: - -Q/
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc