HomeMy WebLinkAboutDriveway Street Cut Permits 27 Bayberry Permit No. 3489 Town of South Windsor, CT
Date 05/09/2003 Street Excavation Permit
Expiration Date 05/08/2004
Descrip:
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Applicant., Loca,t!,on
Name 13OUTIN & SONS
0
7 BAYBERRY.
Addr- 121 WINDSORVIL,LE: ROAD
BROAD BROOK CT 06018 . ...........
............
T.pe of Work >DRIVESIAY
Phone (860)623-2526i�
Applicant agrees to furnish Wi ,�ds
ot. the amount of bond
required and to r
e.J'.M T ..
any::..expenses
incurred by the Town fbr:ih,�f pair,wor; i:n: 80naec
. htenafiE:4:1
r 'repair''' -K tion with this
permit and that applicant 1:cant mi. -W:th. an..' will abide. .th
e rules and
regulations for permits as outlined A
h N.Wfi' of s6iAh lid i sor's Street
��
,
Cut Permit Manual
PERMIT TO 4BE KEPT ON:J0]§::SI-:TE:'AT ALL TIMES.
Issued by
Date Completed Inspected By
' APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC TOWN HALL RTMENT 14 $q
1540 SULLIVAN AVENUE /
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm �- S Phone No.
Address of Firm
Location of proposed work 27 Bay errs Trail
Describe fully nature of permit requested Strip existing—driveway, dress , grade, r511 anU P are
Starting date Approx.ifine for completion
Call before you dig no. Traffic Services Coritrbl o.
Show sketch of proposed work or furnish �'ti -
To b filled out by Town of So: Windsor
two copies of sep rate drawing Pa ement
Indicate Nort
op.size of cut
o.cuts
Amt.of Deposit S by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
o ' Final Billing S
Amt.Due Payee S
Amt.Due Town S
Applicant is responsible for conta g
the Police Dept.and C.B.Y.D. by date
I AGREE TQ FURNISH TO THE TOWN OF SOUTH WI R THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SOUTH WI�DSOR FOR ANY EXPENSES INCURRED BY TH WN 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: L'liO���/K �G��GC��S%`--� S O 4
Date:
Title: ,--5�—
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
lot
.► ' Job Location: 1
Description:
Quote Good for 60 Days.
Special Attention: 1/2 Payment Upon Starti g, Balance Upon Completion.
t
a Contrac wet' rmit
ONE YEAR GUARANTEE ON WORKMAN HIP &MATERIALS.
31�a C
CBUD � Date S