HomeMy WebLinkAboutStreet Cut Permits 9999 Barber Hill Roa (3) 1400026 TOWN OF SOUTH WINDSOR
PERMIT NUMBER C T
STREET CUT PUBLIC UTILITY
DATE: 02/11/2014
GIS ID: 99990780
MUNIS APPLICATION# 201400132 - FEE: 0.00
EXPIRATION DATE:
APPLICANT -;: LOCATION
NAME: CONNECTICUT Wkf'ER COMPA
ADDRESS: 25 NORTH ROAD ADDRE$S: 9909 AARBER HILL ROAD
NY
OWNLR. TO)NOF SOUTH WINDSOR
EAST WINDSOR, GT-_6
1340 SILLIVAN AVE
PHONE 860-623-3355 = = S�DSOR, CT 060742734
WORK DESCRIPTION: INSITAL INCH WATER MAIN TO PROVIDR SIr ZVICE TO#204
BAR$I R HILL- 6 WOOD CONSTR WILL B1 INS [Z LING CONTRACTOR
APPLICANT AGREES TO FURNISH THI TOW- -_,I QF SOUTH WINDSOR THE"AMOUNT OF$OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR'MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR' STREET CUT PERMIT MANUAL.
ISSUED BY ,
DATE 1NSPECTED INSPECTED BY
2/11/2014 1:50 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: y
LOCATION: id , -
TYPE OF WORK: VIS I J21
.Ooj ('oYS �D c�'l� GrcIC
DATE INSP NEEDED: DATE INSP: _21/V 1 f
INSPECTED BY: +�
WORK IN
PROGRESS:
t
V f lQ
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: I lh
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION- PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL.
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
-Name of Firm LQt74rc.ylcur 14ll*rr'Y- Ca .
Phone No.. rGL� Z � 2�09
Address of Firm - 2 5" A/oa th 12b. �Ews r c.�dD2Cr • [aGp
Location of proposed work
Describe fully nature of permit requested .s 5 rv`c b'" w,¢,-�.,c , I ,,� rav•a�e, rz-�
Scx vire, ry w Zo y '6w,"6eit - 1tJcaA C�ytsrf2v�rrdh I�,G�� .YA,
Starting date 17rtcs-y her el .o /3 Approx.time for completion / 1vee-Ir- carr,, Ycrca2
Call Before You Dig No. -?0/3 5'/po 2 75- Traffic Services Control No.
Show sketch of proposed work or fumish Thls section to be filled out by
two copies of separate drawing Indicate North Town of South'Windsor
Pavement Cut
No.cuts
Est:Size of Perm.Patch(s)
Est.PvL Thickness In.
Est.Unit Price$
a r41 Amt.of Deposit$
Total Due$ by
( )Cash( )Check#
Pennanent Patch
No. Cuts
Size of Patch(s).
Final Billing
Amt.Due Payee
Amt.Due Town
�R/f26fll Fit By
Applicant Is responsible 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
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL.ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS INED IN TJJE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Sign Date:__ /ZZ3,r/3
Title: Driver's License
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES