HomeMy WebLinkAboutStreet Cut Permit 08109999 Bayberry Trai 800148 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
• °m " '::v N H STREET CUT PERMIT
DATE: 08/26/08
GIS ID: 08109999
DATE:
MIJNI !H.
S APPLICAT FEE:
ION# 200801328 25.00
F EPIRATIOIV 08/26/09
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APPLICANT 7 >:}
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NNAME: TELE-NETWORKS
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ADDRESS: 31 BAKEWELL COiIki' s.€'. , < � ." - I2Y TRAIL
CRASTON,RI 0292 �' x` : ."'«', �� H WINDSOR TOWN OF
` r h< .4-0 41.L>IVAN AV
PHONE 401-461-8420 n „ WI R,CT 060742711
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WORK DESCRIPTION: REPI k E CA'I V LCaNf
APPLICANT AGREES TO FURNISH THE'I pV�? OF S(UTIf
THE TOWN OF SOUTH WINDSOR Y;: A
FOR AN 1Vt(}I7N3iF BOND REQUIRED AND TO REIMBURSE
x
CONNECTION WITH THIS PERMIT AND THE �I 'T 0 1F0 MAINTENANCE OR REPAIR WORK IN
FOR PERMITS AS OUTLINED IN THE TOWN OF LL IT IIUDA BY THE RULES AND REGULATIONS
ISSUED BY :.x
DAT IN PECTED INSPEC y
8/26/20082:13PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: L" CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: r I9 09
INSPECTED BY:
WORK IN
PROGRESS:
AS-BUILT:
INPUT: / �
---b� V� DATE: '(�
W/2007 Town of South Windsor INPSEMON REPORT 07
HrrLtt*AI iUN t-UK STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit o
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
t SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm . dry phone No.op� - �
6 -00
Address of FirmP ✓� S � ��� �Z l
Location of proposed work_� ��i'4 6j��'��°"�j .�f-,r�
Describe fully nature of permit requested C C'Oa V
Starting date '
Call Before You Dig No 3 BCD Approx.time-for completion
Traffic Services Control No.
Show sketch of Proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out by
Town of South Windsor
Pavement Cut
No:cuts
Est..Sge of Perm.PaWs)
Est.Pvt.Thickness in.
Est.-Unit Price$
Amt,of Deposit$
Total Due$ by
( )Cash( )Check#
Permanent Patch .
No. Cuts
Size of Patch(s)
------ Final Billing .
Amt.Due Payee
Amt.Due Town
By
Applicant Is responsible for contacting the Police De Land 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 PERMIT AND THAT 1 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.
igned:
Date:
Title:
Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES