HomeMy WebLinkAboutStreet Cut Permit 56 Tumble Brook Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3794 Cont.:�.ae'6r hCONNECt'I°GUT WATER COMPANY
Location 0056 TUMBLE BROOK DRI s °
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Type Work WATER. WIND t �-4"Q„6088
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Permit No. 3794 Town of South Windsor, CT
Date 07/12/2004 Street Excavation Permit
Expiration Date 07 12 2005
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Descrip: EMERGENCY REPAIR OF 4 TE
Applicantai ' - .. ..r F r'hz. { � ' Ltisyesaion
Name CONNECTICUT WATE WO ANY-,
m T 3ROQ,Kxk�7�1}I gY
Addr. 25 NORTH ROAD f "
C 6 o
:EAST WINDSOR ';
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Phone (860)292-5552
Applicant a re ' � Vim: F y.:.....• k
PP g e sstb� u 'U. the e�w� ` h W� he'�`Im6unt of bond
required and to re'mb` Town ... t >� dsor , '
u;r � r2yt ep nses
incurred by the ToWr bt,. �_ e e a"
.. . X+• rk iifbntin with this
permit and that appin 3' miit14`a :' y the rules and
regulations for per -.. a int .or's Street
, `
10,
Cut Permit Manual. x
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* * PERMIT O IT
Issued by �'� �" ..•yn�,:.o �`. `�•'. ,��
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Date Completed R`"' drp@' ted By —----------
JUL.312. 2004 12: 29PNPUECONNECTICUT WATER CO;IEE'T EXCAVATION PEFNO._417 P. 2
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1.S40 SULLIVAN AVENUE
SOUTH WINDSoRf CT
FEE $?5.00
Name of firm /r` 7,
phone No. O �3 .�3 s
Address of Firm / r F T
Location of proposed wor y.
Descrlbe fully nature of permit
StarEi g date �7 ,approx.time for completion
Call Before You Dig No. DOy2 F30 ~~ �Tlaf{9c Sary ew Control No
Show sketch of proposed work or furnish To be filledout by Town of§gUth Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut D
No.cuts 1
see, �G Amt.of Deposit$ _ by
4� ()Cash ()check#„
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt, Due Payee$ ,
Amt. Dye Town$
Applicant Is responsible for contacting by date
the ilnllce Dept.and C.B.Y.D.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OP BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNEMON WITH THIS
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ASIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSOR5 STREr CUT PERMIT MANUAL.
Signed: bate•
D,L.*:
PERMIT"SHALL RE KEPT ON JORSVE AT ALL TIMES
smndard r0rm9\Permit5\Shreet Exmvatlon Permkdoc
JUL,s12, 2004 12: 29PM CONNECTICUT WATER CO NO- 417 P. 3
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