HomeMy WebLinkAboutDriveway Street Cut Permits 1017 Foster Permit No. 2857 Town of South Windsor, CT
Date 09/02/1999 Street Excavation Permit
Expiration Date 09/01/2000
Descrip:
Applicant
Location
Name BOUTIN & SONS 1i717 _ RSTR STREET
Addr. 121 WINDSORVILLE ROAM,.'
. BROAD BROOK CT 06016
Type f Work, DRIVEWAY
Phone (860)623-2526 _
Applicant agrees to fu'rr�'lh the I awn aia South yV i ndsor the amount of bond
required and to reimb`ur e' t ow o .Seth Win or Mfpr any expenses
incurred by the Town ,fo, a7itentoe repai rr' Dior i connection with this
permit and that appl i.c,4hit 1; °f t' gigi.
'. ..41th and�*il l; abide by the rules and
regulations for permitse ,as,. t1 tl� it�-, tf a Towr1 of South Windsor's Street
Cut Permit Manual .
fi
* RMIT TO KL=PT %CAN .Jq SITE AT ALL TIMES'.
Issued by Title
Date Completed 1 _ 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 �, J' 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. 1-�7-J S' 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
Cash O Check#
Cut size after Perm. Patch
V � .
No. Cuts
�p ! Final Billing S
Amt. Due Payee $
Amt. Due Town $
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 R;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: Date:
Title: D.L.M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES