HomeMy WebLinkAboutDriveway Street Cut Permit 70 Ash Road Permit No. 2701 �_y Town of South Winasor. CT
Date 05/27/1999 Street Excavation Permit
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Expiration Date 05/26/2000
Desc r i p:
I Applicant
Location
Name BOUTIN & SONS ' �1 �H� D
I Addr. 121 WINDSORVILLE RC1 rS ,
BROAD BROOK CT 060, 6� �� �°
r � � � �� RTVEWAY
Phone (860)623-2526
Applicant agrees too fu " h th a��T Sip �r I!rLdjor the amount of bond
required and to reimbut^se e;`Tai r y th *j fir,--fOr any expenses
incurred by the Town for 1ri as en r,1' ai M� y qr l in connection with this
permit and that a p p 1 it ant f ° � � i 1 i de by the rules and
regulations for permi 1MI n� 1 n h� w ;of 4„SQ`uth Windsor 's Street
Cut Permit Manual .
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* PERMIT TO 1E KEf ! 9TE °`f, ALL TIMES.
Issued by e�
Date Completed Inspected By
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TOWN HALL
1540 SULLIVAN AVENUE y
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Phone No.1ncx3 CD co
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig No. /T 99 220 / .s'ff k Traffic Services Control No.
Show sketch of proposed work or furnish To o be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North G 1.� Prop.size of cut
No.cuts
Amt.of Deposit$ by
O Cash{)Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
l4umP
Amt. Due Payee$-
i Amt. Due Town$
Applicant is responsible for contacting by date
the Police Dept.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 OUTLINED IN THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
Title:_ D.L.#•
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES