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HomeMy WebLinkAboutStreet Cut Permits 21 Pine Knob Circle (2) 1300215 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 08/22/2013 GIS ID: 71700021 - MUNIS APPLICATION# 201301191 - FEE: 0.00 EXPIRATION DATE: APPLICANVIfLOCATION NAME: CONNECTICUT WATf'R COMPANY ' D R E ES 2J PIi�I�KNOB CIRCLE ADDRESS: 25 NORTH ROAD = %' E THURR( TT NANCIBELLE R&IRVING J EAST WINDSOR,CT 06A98 fiE SNOB CIRCLE TI W INDSOR CT 06074 PHONE 860-623-3355 y is ` WORK DESCRIPTION: EXCAVA-- FQI A E tI� � SY APPLICANT AGREES TO FURNISH THE P WI�F SOUTH 1D RT REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR AN*E PENSI S INt ItEAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THAPP1 ICANT IS IV) IA WLAIS W ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OifliTIfJI1I3SI{ TREEFCIJT PERIIIT MANUAL. lv ISSUED BY DATE INCTED INSPECTED BY 8/22/2013 8:53 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** ,. As xWa % i ;, 3M It -i TOWN OF SOUTH WINDSOR INSPECTION REPORT d PERMIT NO.: C7 0� CONTRACTOR: LOCATION: f 1 vie k-►)C3,� C 1 1 e TYPE OFWORK:_Ey/*4ket DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: -f-kree.. S+-ej2 C�J McA_ .e_ �i J f err ins : CnV\c� ®kl-� C"- OcwLe- &f-\ SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: d3 W/2007 Town of South Windsor INPSECTION REPORT 07 APPLICATION FOR STREET EXCAVATION. PERMIT TOWN OF SOUTH WINDSOR Pen-T it No. PU13LIC WORKS DEPARTMENT TOWN FALL 1540 SULLIVAN AVENUE SOUTH w tDSOR, CT 0f074 FOE $26.60 �����Name of Firm. os Phone No. 8L-0- 2 Z-• Address of Firm /tLe27ly Location of proposed Describe fully nature of permit requestedX Starting date Approx.time for completion 4!gvrA(0 �3,i�r Call Before You Dig No. 2©13 ' 3 D 3,8 7 Z Traffic Services Control No. Show sketch of proposed work or furnish two copies of separate.drawing r° Indicate North This section go be tilted out&rN 'B'own ofSouth2EIndsor Pavement Cut No.casts g rY Est'Size of Penn.Patch(s) Est.Pvt TWdmess ire. ' Est Unit Price$ 7v Amt of Deposit$ . O� I � Y �f�•1C _ Total Due$ by E 3 Cash{ )Check# Permanent P2tCh ?irrttr /6/1_ 6 Na, Cuts Size of Patch(s), Final StIrm Post-its'Fax Note 7671 Date #of • pages/ TO From CoMept 1Z Co. - o , Phone# Phone# Applicant is resDonsible for contactin the Police De t and C.B.Y.D. 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 TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTIO-bLWITH THIS PERMIT AND THAT I AM FAMILIAR WrM AND WILL ABIDE BY THE RULES AND iREGULATIONS FOR PERM ,,O INED I E TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Sign True: Driver's License : PERMrr SHALL BE KEPT ON JOBSITE AT ALL TIMES