HomeMy WebLinkAboutDriveway Street Cut Permits 35 Henry Roa (3) Permi,e No: 3109 Town of South Windsor , CT
Date 05/09/2001 Street Excavation Permit
Expiration Date 05/09/2002
Descrip:
Applicant Location
ism
Name BOUTTN & SONS
Addr. 121 WINDSORVILLE RO.A,®
BROAD BROOK CT 060 6 T pe-, of Woltl,�c DRIVEWAY
Phone (860)623-2526
Applicant agrees to fuPt sh `the T ►n`of `"$o�uth: W`("ndsor the amount of bond
required and to reimburse ire "f0 South W�tzrsear for any expenses
i ncurred by the Town far nisi tenanc.eK or r~epai r Wo,r,kin connection with this
permit and that app1 i`c tt t i 'f� i r W 1an l ".W 11~ abide by the rules and
regulations for permits �L 4n Tdwn f_ Sputh Windsor's Street
Cut Permit Manual .
* PERMIT T4, SE KEPT "CN: 408 SITE ,AT' A-LLL--TIMES.
Issued by Title Jo .
J ,fin �._
Date Comp l` t d �Z L 'J �i Inspected By 25; Xt �
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APPLICATION FOR STREET EXCAVATION PERMIT �-----mot
TOWN OF SOUTH WINDSOR X-1"
PUBLIC TOO WN HALL RTMENT -3 f oq
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Const . Co. Phone No. 623-2526
Address of Firm 121 Windsorville Road Rrc)ad Brook ('t nhnl
Location of proposed work - 35 Henry Read
Str1D Txi Gti rig Dri vPwa3T, T1;a nUt l awn area put in pr-AEess
Describe fully nature of permit requested (-rarie�— a nd 1P awe
Starting date Approx.time for completion
Call before you dig no. 20011893413 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 CO e, ,e Prop. size of cut
1 No.cuts
Ib
Amt. of Deposit S by
Cash O Check#
Cut size after Perm. Patch
✓II V V I I
No. Cuts
' N Final Billing $
I
Amt. Due Payee S
Amt. Due Town 6
Applicant is responsible f contacting I
the Police Dept. and C. D. I by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO Rl I[MBURSE 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: r �/ /y2��%��/� Date. 5/4/0 1 _
Title: Secretary D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES