HomeMy WebLinkAboutStreet Cut Permits 9999 Rye Street (5) 1500017 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 04/10/2015
GIS ID: 78609999 FEE: 0.00
MUNIS APPLICATION# 201500308 EXPIRATION DATE:
APPLICANT LOCATION
NAME: CONNECTICUT WATER COMPANY ADDRESS: RYE STREET
ADDRESS: 25 NORTH ROAD OWNER: TOWN OF SOUTH WINDSOR
EAST WINDSOR,CT 06088 1540$ULI,IVAN AVE
SOUTH WINDSOR,CT 06074
PHONE 860-623-3355
WORK DESCRIPTION: EMERGENCY WATER MAIN BREAK REPAIR
APPLICANT AGREES TO FURNISH 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 THE APPLICANT IS FAMILIAR WITH AND WILL'ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
ISSU BY DATE INSPECTED INSPECTED BY
4/10/2015 1:57 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ISOM /7 CONTRACTOR: C_ &)C—
LOCATION:q� S'
j2 d �t �-, � ,z
TYPE OF WORK: atz
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: _f.�✓u�`2.ti Ar �
19,7i4t ilty Adge!y s�,Ari
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: �- DATE: 3
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION.PERMIT
TOWN OF SOUTH WINDSOR Permit
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
' SOUTH WINI)SOR,CT 06074
PEE $25.00
'Name of F Im art. c. ,�>c�,� Z,41' ,
Phone No.. -A,742.—:2,wt7
Address of �,`cs
�.
Location of proposed t+it0
C t. S azoo / �" ----
*- ,Describe fully nature of permit i*ettes#
Starting dao -/;S—
Approx.time for comttm `-� - o2 ,
-Call Before You Dig
-- Traffic Services Control'No
Show sketch'of proposed work or UWslt'
two copies of separate'drawing Indicate North Thls section to be fltled outby
Town of South'Wlndsor
r�hen Pavement Cut
211 No.cuts
. x r 46M, Est:Size of Perm.Patch(s)
Est.Pvt.Thictcness
- in.
- - Est.Unit Price
Amt of Deposit Al '
Total Due: .by
( )Cash( )Check##
Permanent Patch
` No. Cuts
�. .., Size of Patch(s),
Final Billing
7roly Amt.Due Payee
Amt.Due Town
.#ACE T�3�IRNISfi Tt}T# 'I`t;lttV'F+I t3F SOS I - _ - -I DSi13R THE AMQUt OF BONC3�.ta {,�#AIRB3:AW.T4 F IM8t-F 'I I±II`
OVIE :Ql`SOUTIi SDI FOi SiwB iAIC{ I BY'IICE TOWN MR � f3R;I�A1R°WOI�IC 1 '
SON fIT(,#TMIS I E II ArNQ. fAT I AM'PA►Ilt~' A; QC.f .IC }'N'l[ II=TtltitNU7I3:VIt+tlit' A7D` L A,>8tDI `B t �C1A t, 6_-1ULTCIACSGATP R
Drivel's Llcens"*
PERMIT SHALL BE KEPT ON JOBSiTE AT ALL TIMES
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