HomeMy WebLinkAboutDriveway Street Cut Permits 254 Graham R Permit No. 2481
Date 08/07/1998 Town of South Windsor, CT
Expiration Date 08/07/1999 Street Excavation Permit
Descrip: iPERMIT FEE TRANSFERED FROM PERMIT 2447 WHICH WAS CANCELLED
Applicant
Location
Name BOUTIN & SONS
Addr. 121 WINDSORVILLE ROA,6 , �` OiU� GFpHA4. ROAD
, t BROAD BROOK CT
Phone (860)623-2526 F 1'ypQ o Q� RIVEWAY
Applicant agrees tc trh
required and to re i mbgr Tow �' i`,+ ior the amount of bond
csf nthtndor fob any expenses
incurred by the Town cr a�a na iA connection with this
permit and that appl i(ta
regulations for permi � � and` tl�l r�: i de by the rules and
Cut Permit Manual .
�sloath Windsor's Street
L MY* j* PERMIT O: BE KEPT Q1 d ATE AtL TIMES.
Issued b
Tl.t)e
Date Com let d
�� 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 one 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 S by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
�f / Final Billing S
Amt. Due Payee $
\ 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 RFIMBURSE THE TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS
PERMIT AND TH T I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUT WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES