HomeMy WebLinkAboutStorm Street Cut Permits 20 Wildwood Cir Permit No. 2233 Town of South Windsor, CT
date 08/21/1996 Street Excavation Permit
Expiration Date 08/21/ 1997
Descrip: CONNECT YARD DRAIN TO CATCH -
BASIN,.-Applicant Location
Name SKIPS SEPTIC .0020 WTLd,WP0D CIRCLE
Addr. 27 MUDDY BROOK ROAD
ELLINGTON CT 06029 'lb Work STORM
Phone (860)875-2332
App1 icant agrees to fury tis .the,7awr c Sri k, Windsor the amount of bond
requ�i'rer3 and to rei.mbur a th6 TO M :'of CUth WirYd�o r for any expenses
incurred by"th`e Town for6:vrena ` apai rr in' connection with this
permi t' and that app l i c an C a��MVT,14r Wi th � �d w'� 71 bide by the rules and
regulations for permit's Tqlai~f 6f South Windsor' s Street
Cut Permit Manual .
* PERMIT TO BE 'KEpfi O,N �{�B SI'f,E AT ALL TIMES.
Iss ued by T i -72
i�.
Date Compl�,t�d Inspected By
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- ——— ----
TOWN OF SOUTH WINDSOR INSPECTION REPORT
`C
Perm :f� No. 2233 Contractor SKIPS SEPTIC
Location 0020 WILDWOOD CIRCLE Address 27 MUDDY BROOK ROAD
T* Work STORM ELLINGTON CT 06029
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Phone N.o. (860 )875-2332
Date I nsp Needed f � C?ate, t asp AM .
Time Insp Needed Time nsp.
Inspected By e-
Work in Progress
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I�pht` Date
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
Arnt. Bond Required PUBLIC WORKS DEPARTMENT —
Amt. File — TOWN HALL Permit " 233
Date of Expiration 1540 SULLIVAN AVENUE Date
Ins. on File ( 6Yes > No SOUTH WINDSOR, CT Permit Expires
Expiration Date / FEE $25.00
Name of Firm s,JX/ -S-CPVC- IN
Address of Firm .27 60 fL / Phone No. '�3 2.
Location of proposed work _ 20
Describe fully nature of permit requested la S'TAL C.
Starting date if NO Approx. time for completion — z 9(0
—
Call before you dig No. -�_I atr `/�� yam/ 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 QO
Pavement Cut
O .Indicate North
GpaR�� HouS t Prop. size of out _
No. cuts �
Amt. of Deposit $_ by
Cash { ) Check #
DIrow�I
r' Cut size after Perm Patch
of No. Cuts
Final Billing $
c•84riq /I-Dw00D Amt. Due Payee $ .—
Amt. Due Town $ _-
Applicant is responsible for contacting
the Police Dept. and C.S.Y.D. by date
I agree to funish to the Town of South Windsor the amount of bond required and to reimburse the Town of South Windsor
for any expenses in rr d by a Town for maintenance or repair work in connection with this permit and that I arti
familiar. wit and ide the r and regulations for permits as outlined in the Town of South Windsor's Street Cut Permit Manual.
Sign Title: PX£S
D.L.L.# SS"0!2 Date: p /Z// 7 G
PERM(T SHALL BE ON A ALL TINS
APPROVED: DATE:
TO GINEER
FOR INSPECTOR: Date work started Date Completed
Signed Date
/.L' �TO �Ic 4-5 ,
WHITE - PERMIT PlP� o v PINK - ST. SERVICES
YEL-LOW= ENGINEERING '°""" ' - GOLDENROD FINANCE