HomeMy WebLinkAboutDriveway Street Cut Permits 81 Edgewood Permit No. 3011 Town of South Windsor, CT
Date 08/10/2000 Street Excavation Permit
Expiration Date 08/10/2001 f '
Descrip:
Applicant Location
Name BOUTIN & SONS
C t` E1JG'EWOOD DRIVE
Addr. 121 WINDSORVILLE R0
BROAD BROOK CT 06018 '' ype of la -'k DRIVEWAY
Phone (860)623-2526
Applicant agrees to i`trnla" the Tr�wtn t�f 40ut`'h W.i ndsor the amount of bond
required and to reimburse the Town Smith Wiriisor" for any expenses
incurred by the Town f �^ ' i nnar� c� epa rar 'in connection with this
permit and that applicarl�`=iii ,�famil an ,i h a6d' tivill abide by the rules and
regulations for permita_ at r�, 1~ . Towt�. cifSouth Windsor's Street
Cut Permit Manual .
* PE IT TO B' GCEPT ' AT ;ALL TIMES.
Issued by Title ,.;;
Date Completed _ _-- In By
301 t
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 WindsoririllP Road Rrr)ad Runk , Ct nAnl A
Location of proposed work 81 Edgewood Dr ivp
Describe fully nature of permit requested Strip Driveway, dress with process then pave
Starting date �Approx. time for completion
Call before you dig no. 0003300987 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
i
Amt. of Deposit S by
r� O Cash O Check#
�7 f
� Cut size after Perm. Patch
�D No. Cuts
Final Billing $
2 Amt. Due Payee $
Amt. Due Town 4
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 RF,IMBURSE THE TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN 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: G LJ '� Date• 8/8/00
Title: Secretary D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES