HomeMy WebLinkAboutWater Street Cut Permits 236 Smith Stree Perm* No. 2501 Town of South Windsor, CT
Date 10/07/1998 Street Excavation Permit
Expiration Date 10/07/1999
Descrip: WATER SERVICE TO BE PLACED UNDER PAVEMENT - NO PAVEMENT CUT
Applicant Location
Name STATE LINE SEWER & CONST 00 ;, ;036 8MIT�=.STREET
Addr. 238 SHAKER ROAD
ENFIELD CT 06082 1ryRe 4f Wo .k WATER
Phone (860)749-6176
Applicant agrees to furnish iahe +awno4S+atk� wWtrldor the amount of bond
required and to reimburse thy;. T. wn. off I 'm 46r,� fair any expenses
incurred by the Town for tl fnt0nanid o r pai r wo; r�k ,.i-ry connection with this
permit and that app l i sari t s '1�am i 1 r< W�i and WOJ 1 abide by the rules and
regulations for permits 2-5 l'i'nes in ° } ,Tows o aOt th Windsor's Street
Cut Permit Manual .
* * PERMIT BE:, KEPT QN .JOB ;SITE 'A.T, A�l- TIMES.
Issued by Titl. �ZcJi^ G�-Z
Date Comp a ed -Inspected By
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 Phone No. �(Q 6 '� 4' - Ce ( �(a
Address of Firm �` C C&OC—o-
Location of proposed work_ 3 (D
Describe fully nature of permit requested (A b AA)0Z
Starting date Approx.time for completion /-)Le%,,5
Call before you dig no. $�/1C�/�t/to Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut L L-L
No.cuts
Amt.of Deposit 8 by
<> � Coe(-1- -t7y r,J er () Cash()Check#
M Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee S
$
Applicant is responsible for contacting Amt. Due Town
the Police Dept. and C.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO R QMBURSE 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:_ (Q'-7_c?
f7�( PEHL
Title: D.L.# ((012 7 1). t C-F
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES