HomeMy WebLinkAboutDriveway Street Cut Permits 179 Bayberry Permit No. �g859 Town of South Windsor, CT
Date 09/03/1999 Street Excavation Permit
Expiration Date 09/02/2000
Descrip:
Applicant Location
Name BLUE -DIAMOND PAVING 1N 017 ° ,BAY BE RY TRAIL
Addr. 1064 EAST ST NORTH .
SUFFIELD, CT 06078 T of a'rDRIVEWAY
Phone
Applicant agrees to fut��sf ,; the."' Town of youth".,Windsor the amount of bond
required and to reimburse" To rn:p South Wir`ritis r :for any expenses
incurred by the Town ";for main enance or �repair arty in connection with this
permit and that appl i c tr ; f° jgkr with°,..and,;w"i"11 abide by the rules and
regulations for permits 'as',,)ott'tl ine"d �" tie"Town of South Windsor' s Street
Cult Permit Manual .
* * ERMIT T ..B. KEPT '4N 4,0B SITE -AT ALL TIMES.
Issued by
Date Completes Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS-DEPARTMENT
TOWN HALL,_
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Finn2L— A&AI Phone No.266. 7A 0,'Aa, Y
Address of Firm:
Location of proposed work
Describe fully nature of permit requested_KC !` ,r
Starting date Approx.time for completion c
Cali Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish Ta be filled out by Town of South Windsor
two copies of separate drawing
T s, Pavement Cut
Indicate North •
v, �----. Prop.size of cut
No.cuts
Amt.of Deposit$ by
* OCash OCheck#
ab / a• Cut size after Perm. Patch
No. Cuts
Final Billing$
_Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting by date
the Police De t..and C.B.Y.D.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR l kiE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SQUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANI E 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.
l31
Signed:e� C Date: /
Title: N IIYLY
D.L.#:
. 'SEP 2 1999 ,
PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES
Or V
Standard Forms\Permits\Street Excavation Permit.doc 6 $