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HomeMy WebLinkAboutSewer Lateral Street Cut Permits 21 Well Permit No. 2355 Date 09/23/1997 Town of South Windsor, CT Expiration Date 09/23/ 1998 Street Excavation Permit Uescrip; CK3962 IS FOR PATCH FEE & CK2398 T5 FOR PERMIT FEE Applicant Name SIMSCROFT ECHO FARMS Location Addr. P.O. BOX 581 WELL:ES CANE SIMSBURY CT 06070 Phone (860)651-0231 Type; of Work NEW SAN LAT Applicant agrees to furnish the Town of 'S©uth Windsor required and to reimburse the .Town of South Wi ncispr `for any expenses incurred by the Town for, %6intenanG .ar' pair' ydrK 'i the amount of bond Permit and that applicant 1S faml � iar w �`th and wi � 1 ab7de wi n connection with this regulations for permits as dut'line�l in -the Town �c�f South Windsor 's by user and Cut Permit Manual . Street * ? PERMIT TO BE EPT .pN "JQ$ .S"IfiE AT ALL TIMES, * �c Issued by 1 ti T i t e ;--� Date Completed -- Inspected By y� APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC TOWN HALL RTMENT 1540 SULLIVAN AVENUE 2' SOUTH WINDSOR, CT FEE $25.00 Name of Firm S•`/'►'L S C✓t1�� C 14s -.f. 441ri phone No. (J C D 36 N Address of Firm—pa b4by8 C 7 Q Location of proposed work Describe fully nature of permit requested e. ,a-.- Starting date Approx.time for completion Call before you dig no. Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of So Windsor two copies of separate drawing Pavement Cut Indicate North Prop.size of cut ( /N No.cuts_ Amt.of Deposit$ CY, 0 by ()Cash Check# i 2 Z ` �Q J Cut size after Perm. Patch No.Cuts Final Billing $ Amt. Due Payee $ Amt.Due Town $ Applicant is responsible for contacting 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 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 WINDSOR'S STREET CUT PERMIT MANUAL. Signed: , .. Date• l- S7 Title: D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES