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HomeMy WebLinkAboutDriveway Street Cut Permits 321 Benedict (2) Permit No. 2320 � � Town of "South Windsor, CT Date 0�7/23/1997 Street Excavation Permit Expiration Date 07/23/1998 Descrip: PERMIT CANCELLED. LEWIS PAVING 'DID WORK. FEE APPLIED TO PERMIT2375 Applicant Location Name BOUTIN & SONS 0�321 �B�ENED'ICT DRIVE Addr. 121 WINDSORVILLE RQAQ �� � � ��' BROAD BROOK CT 06016 � � Type o1=; Wor�C DRIVEWAY Phone (860)623-2526 App1 icant agrees to �fur�aish theT,awn of Sac%th Windsor the amount of bond required and to reimbwrse the`��,Town ofi 5�u�h Wi�n��o�r .��o'r any expenses incurred by the Town fora rna�ra�e�a�� ar re�pair.� wa:rk �t�rl° connection with this h permit and that appl icant�� ��, �'ar�#.��a�ar�'�it�' and��i`i:i � �"'abide by the rules and regulations for permits ,as `©u�'��.r��+cJ� i.n �th� Tow�� �o�f�Sc�th Windsor's Street Cut Permit Manual . �.� . , * * PERMIT TO �lw I{EPT�. ON J'OB°� SITE. AT 'ALL TIMES. Issued by - �� ���� Title Date Completed Inspected By ... - APPLICATION OWON OF SOUTEXCAVATION WINDSOR N�PERMIT PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm u _Phone No. 7 (� Address of Firm o Location of proposed work 1 Describe fully nature of permit requested A l/f.W Starting date Approx.time for completion Call before you dig no. Q ��c7 �`� _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 Indicate North Prop.size of cut No. cuts Amt. of Deposit S by O Cash O Check# / / Cut size after Perm. Patch{ No.Cuts 1� Final Billing $ 0u`1� Amt. Due Payee $ Amt. Due Town $ Applicant is responsible for contacting the Police Dept.and C.B.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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OFVSOUTHWINDSOR'S STREET CUT PERMIT MANUAL. Signed: I Date: Title: D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES