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HomeMy WebLinkAboutExtension of Main sewer line Street Cut _BOND NS 7©f .. TOWN OF SOUTH WINDSOR - - ,Am't Req. PUBLIC WORKS DEPARTMENTFDate ' TOWN HALL m't on Fi4�e, 1540 .SULLIVAN AVENUEate of Expiration SOUTH WINDSOR;CT 06074 o. APPLICATION FOR PERMIT . Permit Expires FEE Name and address of'a plicant r Phone No. �, Location ofproposed work Describe f lly nature of permit reque�ste Insu,�ance on File with Tow Dat _ n es no' q NaM of Insurer e policy expires o Appronmat:e time for completion esir.ed starting to Call before you dig ticket P10. 9041099 ''7 a Shrw' sketch of proposed work or furnish 2 copies of separate !O!/c�. p rate drawings S o 0 1. One' way ra f f ' e7 - 934 y � is= will be maintained during daylight ,hours, the road . }1 be open to unrestricted two way traffic overnight. y 2. Any changes from the approved plan shall be on the standard chap e a) order form. Approved by the design;engineer, the applicant and a down staff. Such' as location of tees, wyes or laterals. 3,. �'his' proposal is for 8" sanitary sewer with associated structures,. o and., laterals. 0+0 to 4+60 4. A permanent pavement repair shall be made consistent with, Towrt� ' Standards, copy attached, before 10-30-90.' io Q App�fcaat is responsible for contacting the Police Department and CALL BEFORE YOU DIG. 71 I a ce to furnish to the Town of South Windsor the amount of;,bond or deposit required, to reimbui�o'the Town of South Windsor for any expenses incurred b t_he_Town form ntenan g # work m connection with this y regulaifons for Permit and that I am familiar ,witfi and, will abide ,by 'tom runes and permits:as outlined in the Town of,South Wodsor's (Pa ement Cut . l dahs. r Sig APPROVED. DATE AP Supt. of Highways DATE ngineer'� 4 70X�&SPECTOR:,. Date -work sta;�-t+ed ufficient.noti icaation received.. a Date completed Unusual",condi :ions a �euTst�+�ga a Type of-repair:. Per Material clips attac$eo: �e >`, Date "for errfianent repair }Y'ro Signed.