HomeMy WebLinkAboutStreet Cut Permit 30 Foster Street 800150 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/28/08 r
GIS ID:33600030 FEE: 25.00
MUNIS APPLICATION# 200801342 f
}' t{ ,'•;,` , y„ �'r},.t{ . . - IRATION DATE: 08/28/09
APPLICANTx LOCATION
NAME: TELE-NETWORKS F1JSTR STREET
ADDRESS: 31 BAKEWELL CO ., # `r AUTHORITY
CRASTON,RI 0292 f k OT SUL�IVAN AVE
PHONE 401-461-8420
INDSOR,CT 06074
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WORK DESCRIPTION: REP ISI
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APPLICANT AGREES TO FURNISH THE OIOU Ts ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A�'� I1�f x AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH[F OAN
ITIW1L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF` QU- . SW UT • IT MANUAL.
C.
ISSUED BY DATE INSPECTED INSPECTED BY
8/28/200811:52AM ***PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT'NO.: 8 �Sa CONTRACTOR:
LOCATION: 5
TYPE OF WORK:_ m V
DATE INSP NEEDED: DATE INSP: bf
INSPECTED BY: + �
WORK IN
PROGRESS: 1 M If Lm..o 44 11 �4
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AS-BUILT:
INPUT:_ YY DATE:_ 1 Q
W/2007 Town of South Windsor INPSECTION REPORT 07
r1rrL11.*AI IUN IrVK STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR - ___:__
PUBLIC WORKS DEPARTMENT Permit No. .
: TOWN HALL
1640 SULLIVAN-AVENUE
SOUTH WINDSOR, CT 06074
tt FEE $25.00
Name of Fi •1 �-WtSY`L1__S
Address of Firms
Location of proposed work /
Describe fully nature of permit requested r{'P �q
Starting date
Approx.time for completion 044 y
Call Before You Dig No�U `3 Traffic Services Control No.
Show sketch of proposed work or furnish
two coPies-of separate drawing Indicate North This section to be filled out by
Town of South Windsor
Pavement Cut
No:cuts
Est Size of Perm.Patch(s)
l� Est.PvL Thi kmw in.
e Q/d r,CLed• Est.Unit Price S
AmL of Deposit$
Total Due$ by
c )Cash( )Check#
Permanent Patch .
No. Cuts
Size of Paws)
Final Billing .
Amt,Due Payee
Amt.Due Town
S
By
Applicant is responsible for contacting the Police Dept and C.B.Y.D. Date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SOUTH WINDSOR YOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THAT I AM FAMOAR WITH AND WILL A131DE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN TIME TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
igned: Date:
Driver's License M
• PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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