HomeMy WebLinkAboutDriveway Street Cut Permits 50 Edgewood Permit Ito. 3018 Town of South Windsor, CT
Date 08/24/2000 Street Excavation Permit
Expiration Date 08/24/2001
Descrip:
Applicant Location
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Name BOUTIN & SONS ,��: 1S0&O: �DG�E OD DRIVE
Addr. 121 WINDSORVILLE RQJ
BROAD BROOK CT 06016 Typo -of W�;rk :DRIVEWAY
Phone (860)623-2526 "
Applicant agrees to i:u,r5i� the wTpwn o fl `'
. tha.WA nd`sor the amount of bond
required and to reimburse �"; o� cif �tjth "�V1rds °M"1 or any expenses
incurred by the Town *foriairtena�nce` or..repa �' work in connection with this
permit and that applic ht f f r tk and wl 11� abide by the rules and
regulations for perms s ae "+C cr^t l fffOtiwra of South Windsor's Street
Cut Permit Manual .
* PERMIT, TO BE KEPT, N':' J,"OB" S: "T"E;AT " ALL TIMES.
.ssued by
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ate Complet�d � Inspected By
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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 Firm Boutin & Sons Const. Co. Phone No. 623-2526
Address of Firm 121 Windsorville Road Rrnad Rrnnk i ('t o6nl F
Location of proposed work 50 Edgewood Drive
Describe fully nature of permit requested Strip, dress and pave driveway
Starting date Approx.time for completion
Call before you dig no. 20003402913 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
5 No. cuts
Amt. of Deposit S by
36 19 () 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.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO RFIMBURSE 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 OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: '-�Jr Date: 8/18/00
Title: Secretary D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES