HomeMy WebLinkAboutStreet Cut Permit 2 Clover Drive Permit No. 2430 Town of South Windsor, CT
Date v 05/07/1998 Street Excavation Permit
Expiration Date 05/07/1999
Descrip:
Applicant Location
Name BOUTIN & SONS 40t2,,CLOVER"ORIVE
Addr. 121 WINDSORVILLE ROAD `
BROAD BROOK CT 06016 Ty0e cif Work DRIVEWAY
Phone (860)623-2526
Applicant agrees to furnish ,the Town of South Wiindsor the amount of bond
required and to reimburse;,the�. Town of i8outh W'Vndsbr` fo- any expenses
incurred by the Town for . mair�-tenance c�`r; repair -hark fin' connection with this
permit and that applicant rts familiar w th. and will >ab-ide by the rules and
regulations for permits' as outll l ned in the. Town .,of South Windsor ' s Street
Cut Permit Manual .
* * PERMIT TO BE KEPT O ' 09: 11E ,AT_ALL TIMES.
Issued by �" %J >G�� Title 6 /_
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm_
Address of Firm Phone No._�
� � 1 � r � '
Location of proposed work
Describe fully nature of permit requested ; ,°i i '1 t.f
Starting dateApprox.time for completion
Call before you dig no. ; `� o'j I ,'r'
—r.=—� � i Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of SO Windsor
two copies of separate drawing Pavement Cut
Indic�te North I
Prop, size of cut
No. cuts
{ Amt. of Deposit S by
O Cash O Check#
I
1
f Cut size after Perm. Patch
r
9�
No. Cuts
i{ Final Billing S
Amt. Due Payee S
Applicant is responsible for contacting Amt. Due Town $
the Police Dept. and C.S.Y.D. by date
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 OUTLINED IN THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
1
Signed.
Date
Title D.L.+Y
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES