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HomeMy WebLinkAboutExcavate to install water main to Tuscan 800164 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 09/17/08 GIS ID: 15300206 h" 'A FEE: 25.00 MUNIS APPLICATION# 200801454 :'EXPjRATION DATE: 09/17/09 APPLICANT :..:,:....:.. >:......: ':LOCATION SIMSCROFT ECHO FA.RMS.. `;" ~<., "'<'"<: <.�.:::.•�1DRBS5a,,;,,:2�16 BUC�IAND ROAD ::..", ADDRESS: P O BOX 581 `C3;:°:> ?;. «r B OTT ILLE MARRION&ROY SIMSBURY CT 0 600:x: ]DRUM"IN ROAD 3axYf: ``�' ST E� SBU RY M CT 06092 5 PHONE —860 651-0231 F� '•�.:is�.':i y.�8:. WORK DESCRIPTION: EXCA`• '.' `'� "t �'T �TALia.��`< ;T;: '� '�: �Ct: >'ILLS SITE 'C APPLICANT AGREE S URNISH TH E W :5.;C U1 t' ' , D REQUIRED AND TO REI MBURSE THE TOWN OF SOUTH WINDSOR FOR AN ,L RNS 1wIAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE' P. CAT kIS FAIT ,::kfi I$AND L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SQLfTE WI11D.5R'..S.STRFEJ1 pE1TVIIT MANUAL. 5- PLPJA rx ISSUED BY DATE INSPECTED INSPECTED BY 9/17/20084:26PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** • TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: LOCATION: TYPE OF WORK: - --- DATE INSP NEEDED: --------__ DATE INSP: INSPECTED BY: WORK IN PROGRESS:- AS-BUILT: INPUT: C4AA_._, DATE: c `/T' O W/2007 Town of South Windsor INPSECTION REPORT 07 Hrrut.H I lute t-UK STREET EXCAVATION PERM-IT c�16¢ -�� '1�-5�- TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No. TOWN HALL + 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm C Address of Firm uC; j�� Phone No. Location of proposed work t �" `USc�,.N r�►ils Si-�, ' Describe fully nature of permit requested a 4 Starting date / -- U Approx.time for completion Call Before You Dig No. ,Z n1 -��c) - Traffic Services Control No. Show sketch of proposed work or fumish two copies of separate drawing Indicate North This section to be filled out by Town of South Windsor Pavement Cut l No:cuts ' Est.Size of Perin.Patch(s) "'3 a , Est.Pvt.Thid mew G5 in. Est Unit Price$ 3`7 C� I Amt.of Deposit$ 1 Total Due$ by ( �)Cash � Check# S� I --�--. -Permanent Patch . No. Cuts Size of Patch(s) --__.-- Final Billing . Amt.Due Payee Amt.Due Town Applicant is responsible for contacting the Police Dept.and C.B.Y.D. Date 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 P RMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLtNED-1 OF WINDSOR'S STREET CUT PERMIT MANUAL. Signed: 44 Date:_ Title: Driver's License PERMITS ALL BE PT ON JOBSITE AT ALL TIMES i 1•Q �Q QQ / � ®I• �QQI/Q ®® /QQQQ/ Q� I/ Q/!tiQ/Q ;J�Q�QQQr///�... ■�i��iQQQ� /� Q�//QAiI�,�.iet�s���tt��>•[i>�'��QEI!/1 E/�i/Q//Q/QQt////Q/Q®itQ///t!Q 1�1�//t//QQI/tQsliQQ//!/llli//�Q //Qt//tQ � ��/QQ>•Q/1"mm1�QQ/!//Q ■QI/IH1QQQtt//Q/ ///i////// QI�QQIIQ�QQ/Q Q/QQQ/ /�Qi / /Q/Ql•l��/1 Q //Q//Q�Q//>I/Q// 11Q////Q/Q/QI�//1•/Ql!///1Q//BQf//iQIfQQQ/Q////Q>f/ QRlaw A� ��<Qfi��u�ItQ/11�//■QQQQ will © ��� ■®Q QQQQr>i