HomeMy WebLinkAboutDriveway Street Cut Permits 56 Hazel Dri Permit No. 2991 Town of South Windsor, CT
Date 07/10/2000 Street Excavation Permit
Expiration Date 07/10/2001
Descrip:
Applicant Location
Name BOUTIN & SONS 0 6 41AZEL,' STREET
Addr. 121 WINDSORVILLE RC3A
BROAD BROOK CT 060:16 ',Ype p k DRIVEWAY
Phone (860)623-2526
Applicant agrees for the fi "',of eb�t �WIndsor the amount of bond
required and to reimburse �e Town of �oUth Windsor .for any expenses
incurred by the Town ;f6r A],* » repa $ t oirk ire connection with this
permit and that app77gcdiat rs: f i l a Wig and ,-Wail7„s'abide by the rules and
regulations for permits7;.aslineq in tit Tca �`b � South Windsor's Street
Cut Permit Manual .
* PE IT T04.BE E 'T QJtit' lOg SITE''`AT, ALL TIMES. * xc
Issued by tied %' ,' .-
t
Date Complet d
Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WIDSOR, CT
FEE 25.00
Name of Firm Boutin & Sons Const. Co. 623-2526
Phone No.
Address of Firm 121 Windsorville Road Broad Brook, Ct 06016
Location of proposed work 56 Haze] StraAt
Describe fully nature of permit requested Strip driveway, dress with gravel and. pave
Starting date lApprox. time for completion
Call before you dig no. 20002801344 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
PNo. cuts
Amt. of Deposit $ by
S �
() Cash () Check✓f
Cut size after Perm. Patch
No. Cuts
Final Billing
S
Amt. Due Payee S
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 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.
Signed: _ 2e��l-r/1L/ c Date: 7/6/00
Title: Secretary
D.L.N
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES