HomeMy WebLinkAboutDriveway Street Cut Permits 142 Brook St Permit No. 2494 Town of South Windsor, CT
Gate 09/2, /1998 Street Excavation Permit
Expiration Gate 09/23/1999
Descrip:
Applicant Location
Name BOUTIN & SONS 0442 ,B( OOK .,STREET
Addr, 121 WINDSORVILLE ROA
D,
BROAD BROOK CT 06016 Type q ,'Wpt DRIVEWAY
Phone (860 )623-2526
Applicant agrees to fur.nlsh::.the T(Iav4n ;6,f S 61th .,,Windsor the amount of bond
required and to reimburse .the :Town of St th ► 1 rids it .-for any expenses
incurred by the Town for maintQnaric connection with this
permit and that applicant (s. fami � r w1'thand �r1bide by the rules and
regulations for permits, as ,outiried in th
Cut Permit Manual . e Town cif South Windsor 's Street
* * PERMIT TO. BEaKEPT-
ON,. JOB `�8:1TE ' AT ALL TIMES.
Issued by
TSte
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
��11
Name of Firm T Phone No.
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date �Approx.time for completion
Call before you dig no. 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 $ by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee S
Amt. Due Town S
Applicant is responsible for contacting
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 RF,1MBURSE THE TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOgA¢,4lfJ�NCE OR REPAIR WORK IN CONNECTION WITH THIS
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE 13Y �RULE AND`R ,ULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUALL 5,
tL1!
Signed: e6 S EP 22 19H: r
SOUTH WINDSOR
Title Lk444Eh6.D`PT. D.L.B
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PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES