HomeMy WebLinkAboutStreet Cut Permit 140 Commerce Way Permit No. 4218 Town of South Windsor, CT
Date 05/10/2006 "` +< ;<. Street Excavation Permit
Expiration Date 05/10/2007
Descrip: EXCAVATE TO INSTAL P SEt ^L ""'�_
Applicant t'{, tcar-
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Name COVEN CONSTRUCTIQ'N CO.Addr.. P.O. BOX 427
COVENTRY CT 062 '8<;cj, r . <<�;,,�'Yir .r.`R'RNsSAI IAT r
Phone (860)282-0526
Applicant agrees�?to"' rish_: he TQvxY > 'k..S_y Wind ion;" he'
required and to reibt� 'e :k` ` ~amount of bond
izoiJn '. ` tshF: €ga :;`` r f I'; �i rases
incurred by the Townyfa msxfmanc�or`x�epair nq. with this
permit and that appliaIt i< "_ i` '' ,' 1: .: 'b' d` t
u 2; : ,hy 14 rules and
regulations for ermi g ` � f' 'p t k as .o ift nets y" z xxti` i _ds r s Street
13e'"TiSSY• .c 'So.
Cut Permit Manual. % ` :vmsraw" y< E "c -<TL
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* * PERMIT TOA B:E K�PT oil' i3f�Bs.:�vI1. AP IYLr<iXTIMFw.S�
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Date Completed ___—_------_— Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4218 C ont;x,;a��`or COVEN `CbN,S�TRUCTION CO.
Location BETWEEN 140 AND 130 cic7res;`r
Type Work RPR SAN LAT "•
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APPLICATION FOR STREET EXCAVATION PERMIT �2�g
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm_ �7 c� �-� ��
Address of Firm c� (� ` Phone No (1b1 y7 cj
Location of proposed work
Describe fully nature of permit requested
Starting date 6 0 6 q
Call Before You Dig No. D �Tt�ffme for completion
rvices Control No.
Show sketch of Proposed work or fumish
two copies of separate drawing Indicate North This section to be filled out by
Town of South'Windsor
Pavement Cut
No.cuts
Est.'Size of Penn.Pats)
4x
Est.Pvt.Thickness 4_in.
Est.Unit Price$
Amt.of Deposit$ 3 CC),
Total Due$ 3S5; by
( )Cash(Check# .E 9 44
I" v� G Permanent Patch
��Iry
No. Cuts
» U Size of Patch(s)
Final Billing
Amt.Due Payee
AmL Due Town
By
Applicant is res nsible for contactin
the Police-Dept.and C.B.Y.D. Dal
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 TOVJ1 FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH IS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS UTLI E IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
�ign`ed:
Date: <—,_ a�
tle:
Driver's License#:
IMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
TOWN OFSOUTH WINDSOR
ENGINEERING DEPARTMENT
ADDRESS
PERMIT N0. SHEET
UTILITIES OF
INSPECTOR TEMP.PATCH DATE
INSPECTOR COMPLETION DATE
COMPUTATION RUFFT