HomeMy WebLinkAboutReplaced sidewalks Street Cut Permits St BOND TOWN OF SOUTH WINDSOR N- - 8o 1
Am't Req. PUBLIC WORKS DEPARTMENT
TOWN HALL
Date
Am't on File 1540 SULLIVAN AVENUE
Date of Expiration
SOUTH WINDSOR, CT 06074 Permit No.
APPLICATIO4 FOR PERMIT Permit Expires
FEE /Q —
Name and address of applicant J .M.J . CONST.CO INC
Phone No. 6 4 4-81 3 7
Location of proposed work . V.HOMES
REP i ALSO SETTLEMENT BEHIND TWO CATCH BASINS) ON
Describe fully nature of per requested. F�/
ESCRIPTION
Lnsurance on file with Town yes no 0 Name of Insurer NATIONWIDEDate policy expires
a Approximate time for completion 1 0 DAYS Desired starting date 1 1 /2
cd Call before You dig ticket Pdo. 9
aShow sketch of proposed work or furnish 2 pies o separate 0 co f p rate drawings
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QApplicant 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
reimburse the Town of South Windsor for any expenses incurred by the Town for maintenance or re air
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 Regulations.)
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Signed JEV-MARC CQUES/J .M.J . 00NST . Cj
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APPROVED: DATE L
_APPROVED; DATE
Supt. of Highways 1
o n n neer
� FOR INSPECTOR: Date work started
S.ue,- D
cient notification received: yes no T ate completed
Unusual conditions encountered Type of repair: Perm. Temp.
Material slips attached: yes no Dated for Permanent repair.;
Signed
Inspector