HomeMy WebLinkAboutStreet Cut Utility 1100132 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 08/30/11
GIS ID: 79809999 - FEE: 00
MUNIS APPLICATION# 201100976 = EXPIRATION DATE:
APPLICANT LOCATION
NAME: CONNECTICUT WATER COMPANY-" ADDRESS- SAND DILL ROAD
ADDRESS: 25 NORTH ROAD OWNER: TQWN OF SOUTH WINDSOR
EAST WINDSOR,CT-0IiQ88 1540 SULLIVAN AVE
WINDSOR,CT 060742734
PHONE 860-623-3355
WORK DESCRIPTION: REPLACE DM- 6MED FIRE HYDRANT
APPLICANT AGREES TO FURNISH THE Tt)W ,OF SQUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY=EXPENSES INCURREE BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI APPLICANT-IS F` 1LIAR WITHAND WIi L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 4F 61 TH WINDSR'S`STREETCUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY�G
8/30/20119:18AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERM I
_ IT NO.. I � ,3� CONTRACTOR: C Luc,
LOCATION:
.TYPE OF WORK: 1l'C�
DATE INSP NEEDED: DATE INSP: 1 io /Z,
INSPECTED BY: rib
WORK IN
PROGRESS: OIL A —It
ADA
12
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: V-' DATE:
W12007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION.PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT o6o74
FEE $25.00
Name of Firm � 10- Phone No. S(ao- 252- ,?
Address of Fern f
T
Location of proposed work s v2 g
Descn`be fully nature of permit requested ��� _�
9
Starting date L2 i< Approx.time for cornpletior:_
Call Before You Ding No. Zn t 131i o.3 24,5 Traffic Services Control No.
Show sketch of proposed work or famish This section to be fined out by
two copies of separate drawing Indicate North Town of SouFh Windsor
Pavement Cut
W No.cuts
Est'Size of Perin-Patch(s)
2 SiD�`et�tr!IC Sl.rr Est.Pvt,Thickness in.
Est Unit Price$
Amt of Deposit$
���lLdutCc� �o Total Due$ by
c�iD os ( )Cash( )Check#
Permanent Patch
h No. Cuts
c �!
SA70 '`�'��' Z7 Size of Patch(s)•
Final t3illFng
CwenF z yan
wad Arnt Due Payee
Amt Dine Town
By
Applicant is r onsible forcontacu►
the Police De t and C.S.Y.D.
1 AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND.REX:2UIRED AND TO REIMBURSE THE
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FflR MAIk`[TENANGE OR REPAIR WORK W
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE.TOWN OF SOUTH WINDSOMS STREET CUT PERMIT MANUAL.
Signed Date:
True: Drivees License#
PERMIT SHALL.BE KEPT ON J013SITE AT ALL TIMES