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HomeMy WebLinkAboutMiscellaneous Street Cut Permits Vibert tr. TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3164 Contractor GERBER CONSTRUCTION CO Location TREATMENT PLANT Address 616 DART HILL ROAD Type Work MISCELLAN VERNON CT 06066 Phone No. (860)875-6684 Date Insp NeededDate I n'sp, l6 Time Insp Needed 11Z"DO Time Ins' p Inspected. By Work in Progress y' xcoreaT/ems c o/. �,a c. 'r�,Y-G'.� T�w f?t 4 /��•��� — SST /(/�,� lr�✓ T✓%-- I n,pu,t Date Permit No. 3164 Town of South Windsor , CT Date ` •<- 08/08/2001 Street Excavation Permit Expiration Date 08/08/2002 Descrip: REPLACE MANHOLE TOP Applicant Location Name GERBER CONSTRUCTION CO,;' TREATMENT .,PLANT Addr. 616 DART HILL ROAD VERNON CT 06066 Ty 8 of Work. MISCELLANY Phone (860)876-6684 Applicant agrees to furri i sh ✓thy Tory..of South,-Wi,ndsor the amount of bond required and to reimburse tpn �T. wn �f:`;Sotttrz scar`" for any expenses incurred by the Town for mirienanr `:repai r work ' In connection with this permit and that appl i,ant ae ;fam' l gar�,wx ant; W,11'1;- abide by the rules and regulations for permits° s ©utlIred` ir► :te„Tow1�` C►.f South Windsor's Street Cut Permit Manual . * * PERMIT TO"-®E KEAl", ON°" .!t'3g, ' XTE' AT' ALL TIMES. Issued by �. ?r--jztJA T to Date Completed �6 rspected B �3164- APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR f CT FEE $25.00 Name of Firm C6 COh) 1--y� Phone No. Address of Firm .714 Location of proposed work Describe fully nature of permit requested Starting date Approx.time for aimpletlW Cal Before You Dig No. Traffic Services Control No. Show sketch of proposed work or furnish T„ehe filled out by Town of South Windsor two copies of separate drawing Pavement �0 Indicate North Prop•sme of Cut No.cuts g— .Amt.of Deposit$ by Cash ) 9 Cut size after Perm.Patch s No. Cuts l Final Billing$ Amt.Due Payee$ Amt Due Town$ Applicant is responsible for w cting by date the Police Dept.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 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 WINTv CUT PERMIT MANUAL � 3- © ) Signed: Date: Title: T D.L#: d b PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permitdoc