HomeMy WebLinkAboutDriveway Street Cut Permits 70 Hazel Dri t
Permit No. 2984 Town of South Windsor, CT
Date 06/23/2000 Street Excavation Permit
Expiration Date 06/23/2001
Descrip:
Applicant Location
Name BOUTIN & SONS 0070, HAZ�i�L`STREET
Addr. 121 WINDSORVILLE ROA, f'
BROAD BROOK CT 060,46 . .Ty: fcrk DRIVEWAY
Phone (860)623-2526
Applicant agrees to fur' 3shAethe Turn :cif' South' °Wi.ndsor the amount of bond
required and to W�
reimburse ,te 'Town':.. f youth nisar for any expenses
incurred by the Town for �naintenrrr�epair 1'k in connection with this
permit and that app 1 i cant f rr 1 and i�'i 1 �; .abide by the rules and
regulations for permits .,a A.
WT.,-bf: South Windsor 's Street
Cut Permit Manual .
* PERMIT TO` g ;K P tN JOB SITS �1T. .ALL TIMES.
Issued by Title'
s i
M
Date Completed 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 Boutin & Sons Const. Co. 623-2526
Phone No.
Address of Firm 121 Windsorville Road Broad Brook, Ct 06016
Location of proposed work 70 Hazel Street
Describe fully nature of permit requested Strip Driveway, dress with process and then pave
Starting date 7 15 00 /Approx. time for completion 7/30/00
Call before you dig no. 20002602464 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by To of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop. size of cut
No. cuts
Amt. of Deposit S by
() Cash ( ) Check#
--� -6 !
Cut size after Perm. Patch
No. Cuts
Final Billing $
Amt. Due Payee S
Amt. Due Town b
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 RQIMBURSE 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: 6/2 2/00
Title: Secretary
D.L.A
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES