HomeMy WebLinkAboutDriveway Street Cut Permits 414 Foster S Perm' No. 2299 •Town_ ofa South Windsor, CT
Date 05/i3J1997 "' Street Excavation Permit
Expiration Date 05/13/1998
Descrip:
Applicant Location
Name . BOUTIN & SONS 04J4 `EOST5R STREET
Addr. 121 WINDSORVILLE ROAD
BROAD BROOK CT 06016 Type ' of Work DRIVEWAY
Phone (860)623-2526
Applicant agrees to furnish the Town of South, Windsor the amount of bond
required and to reimburse the 'Town of South WfrIidsor for any expenses
incurred by the Town for maintenance or repair `wnrk 7n" connection with this
permit and, that applicant is familiar with and wi.l1 abide by the rules and
regulations for permits as ;out'1 1 ned i n 'the Town cif South Windsor 's Street
Cut Permit Manual .
'PERMIT TO BE KEPT Gib j6a SI,tEl AT ALL TIMES.
Issued by -• .�""r` T e .-�. .., ..
Date Comp l eted Inspected By
., APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm ' Phone No. �
Address of Firm
Location of proposed work ma
Describe fully nature of permit requested '
Starting date Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North i^ Prop.size of cut
No.cuts
Amt.of Deposit$ by
(►Cash()Check#
Cut size after Perm. Patch
No.Cuts
Final-Billing-$--
Amt.Due Payee$
%VAX 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 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.
JeSigned Date: el
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES