HomeMy WebLinkAboutDriveway Street Cut Permits 60 Woodside Permit No: 2936 Town of South Windsor, CT
Date 03/28/2000 Street Excavation Permit
Expiration Date 03/28/2001
Descrip:
Applicant Location
Name BLUE DIAMOND PAVING 1 �' O,�fW,;WOO�DS'ZDE DRIVE
Addr. 1064 EASTST NORTH .
SUFFIELD, CT 06078, " o ' rkDRIVEWAY
Phone (800)728-4644
Appl icant agrees to i'ur t s i the tcavD d"O SO`tY,,WIndsor the amount of bond
required and to reimt ut=se N ,"fo.�n t�f °SOth V /fAdeor, or any expenses
incurred by the Town for msirll;enanc+e or` : paid" iat�4 in connection with this
permit and that applicafi;t is fa +al ar 'WIV and 'll- abide by the rules and
regulations for permits 'as dvtl iritl in 1h Te►wra af" South Windsor's Street
Cut Permit Manual .
* ERMIT X"E"PT �gN JQB, �ITE ,AT ALL TIMES.
Issued by * P Title' _
Date Complet d In By __
PermiCP�o:` 2936 Town of South Windsor, CT
Date 03/28/2000 Street Excavation Permit
Expiration Date 03/28/2001
-Descrip:
Applicant Location
Name BLUE DIAMOND PAVING INC 0060 °WOODSIDE DRIVE
Addr. 1064 EAST ST NORTH ;
SUFFIELD, CT 06078 Type of. Work DRIVEWAY
Phone (800 )728-4644
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 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 .
PERMIT I E KEPT ON .JOB SITE AT ALL TIMES.
r-
Issued by / _ �"� CJ Ti tip
Date Compl( t ,d _ J --------- ___ Inspected By --
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR `
PUBLIC WORKS DEPARTMENT �JS�
-TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm G I U- 'J i Awwn V 1 Y1 Phone No
Address of Firm .
Location of proposed work d ! r-
Describe fully nature of permit requested
Starting clate—ingr• Approx.time for wmpleton
Call Before You Di No. Traffic Services Control No.
Show sketch of proposed work or furnish _be filled out by Town of So uth Windsor
two copies of separate drawing To
Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
_ {)Cash{)Check#
�11 9v
Cut size after Perm. Patch
- No. Cuts
Final Billing$
Amt.Due Payee$
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 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 WINDSOWS STREET CUT PERMIT MANUAL.
Signed: Date:
Title• Pred
D.L.#•-#-
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc