HomeMy WebLinkAboutWater Street Cut Permits 23 Woodland Dri Permit No. '2259 Town of South Windsor , CT
Date 11/04j1996 Street Excavation Permit
ExpA ration Date 1 1/04/ 1997
Descrip: REPAIR BROKEN WATER MAIN IN FRONT' OF 23 WOODLAND ( IN ISLAND)
Applicant Location
Name CONNECT'ICUT WATER COMPANY 0023 WOODLAND DRIVE
Addr. 25 NORTH ROAD
EAST WINDSOR CT 06088 Type of Work WATER
Phone (860)252-5552
Applicant agrees to furnish 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 applicant is farm � iar with and will aside by the rules and regulations for permits as Outlined .in the Town of South Windsor ' s Street
Cut Permit Manual .
* h PERMIT Tr, KEPT ON, JOB SIT
E AT ,ALL lI S.
Issued by Title
Date Co p Iet 'q . ___ ._.._ .____._.._.. ____._.._ Inspected 8y
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
L AN 6-Z
1540 SULLIVANTOWN
SOUTH WI S ,FEE S✓Cl
e
Name of Firm ' / C _ Phone No. g�-
Address of Firm h ;
Location of proposed work
Describe fully nature of permit requested
Starting date - - Approx.time for completion
Call before you dig no._!61 4-ffofly)) ) Traffic Services Control No.
Show sketch of proposed work or furnish TO be Flied out by Town of So. Windsor
two copies of separate drawing /� Pavement Cut
Indicate North �1 Prop.size of cut
I J 1� No.cuts
v.1
\� Amt.of.Deposit$ by
i O Cash O Check ff
Cut size after Perm. Patch
No.Cuts
23 Final Billing$
Amt. Due Payee $
Amt.Due Town $
Applicant is responsible for cunt ing
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:
Date•
Title: J D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES