HomeMy WebLinkAboutSanitary Lateral Street Cut Permits 946 TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2659 Contractor COVEN CONSTRUCTION CO.
Location 0946 STRONG ROAD Address P.O. BOX 427
Type Work NEW SAN LAT COVENTRY CT 06238
P-honeµ"No. (860)282-0526
Date Insp Needed
Time I nsp Needed T�i mens 'As
Inspected By
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0. 2659 I-own of South Windsor , CT
Date 04/23/1999 Street Excavation Permit
Expiration . Date 04/22/2000
Descrip: .e:.,
Applicant Location
Name COVEN CONSTRUCTIONQ � 8 8 ,RpN' tOAD
Addr. P.O. BOX 427 � d
COVENTRY CT 06238 Type * Work NEW SAN LAT
Phone (860)282-0526R
Applicant agrees to fu t!
4f S� Witior the amount of bond
required and to re imbirea, 0Towndh W r� r any expenses
incurred by the Towner i �
1 ?ai r4�i connection with this
st
permit and that app 1 i ca � ar a 1 7` a i de by the rules and
regulations for permit *, ��S uth Windsor 's Street
Cut Permit Manual .
, gym
* PERMIT BE l<. PT blrf ,1 9" 'SITI€ 'AT ALL TIMES .
Issued by t 1 e
Date Completed 5�3 _ Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR v (off r
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
EE $25.00
Name of Firm C3 V A-) S� 'd /A-C Phone No. F6 0 c�8
Address of Firm IS , )x a 7
Location of proposed work G 4[, Srt ZO A f
Describe fully nature of permit requested i N i tA C C Lo
Starting date a Approx.time for completion_ Q� /
Call Before You Dig No. g 670 5 3 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop. size of cut CA 0-
No.cuts
Amt. of Deposit by
O Cash()Check#
Cut size after Perm. Patch
�f 0 C No. Cuts
Final Billing$
P
Amt. Due Payee$
1
N Amt. Due Town$
Applicant is responsible for contacting by date
the Police De t. and C.B.Y.D.
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 EXPEN ES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS
PERMIT AND THAT I AM F A WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSO 'S ET CUT PERMIT MANUAL.
Signed: Date: �4 3 5
Title:
D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc