HomeMy WebLinkAboutDriveway Street Cut Permits 33 Grace Roa F�ermit No. 2466 Town of South Windsor CT
Date 07/16/1998
Street Excavation Permit
Expiration Date 07/16/1999
Descrip:
Applicant
Location
Name BOUTIN & SONS s
D� fAC� tOAD
Addr. 121 WINDSORVILLE ROA
BROAD BROOK CT 0601,6., .
Phone (860)62.3-2526 ! � ` DRIVEWAY
�� ti
Applicant agrees t6 r" the
A �� �ilor the amount of bond
required and to reimbbrM,
'. w� ��h any expenses
incurred by the Townd , manenc + apain " i connection, with this
permit and that appli
regulations de by the rules and
for permits s „ l i � � � Sth Windsor's Street
Cut Permit Manual .
x �. a
* * PERMIT TO' B XePT`O1 "L TIMES.
Issued by
0111
Date CompletedInspected By
.r. ..C.. all
APPLICATION
OWON OF SOUTEXCAVATION
WINDSOR N PERMIT
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm, e 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 k
GM
Cut size after Perm. Patch
No.Cuts
4
Final Billing $
Amt. Due Payee $
Amt. Due Town $
Applicant is responsible for contacting
the Police Dept. and C.B.Y.D. by date
1 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: lZI /v
-r
Title: D.L.N
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES