HomeMy WebLinkAboutDriveway Street Cut Permits 88 Kelly Roa Permit No. 2483 Town of South Windsor CT
Date 08/12/1998 Street Excavation Permit
Expiration Date 08/12/1999
Descrip:
Applicant . Location
Name BOUTIN & SONS '
g� K K�L AD
Addr. 121 WINDSORVILLE ROAD
BROAD BROOK CT 0601 � ` " ypr% � �oVbt` RIVEWAY
Phone (860)623-2526
Applicant agrees to „furtl� h Che rri - � ta � :� tnd the amount of bond
required and to reimboroe the ;Town .caf youth 1�tb`r .far any expenses
incurred by the Town f6r connection with this
permit and that applicant andil , abide by the rules and
regulations for permits �s CrUirl ird. 1 i; Qw 5uth Windsor's Street
Cut Permit Manual .
* �* F��RMIT T4 KEPT ( J4B'. SITE AT ''ALL TIMES.
Issued by j Tit3e ,� c�Y
Date Complet4,d Inspected By J�.
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 Phone No.
Address of Fir
Location of proposed work
Describe fully nature of permit requested
Starting date 9Y 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 To of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop. size of cut
No. cuts
Amt. of Deposit $ by
1
() Cash() Check#
Cut size after Perm. Patch
No. Cuts
Final Billing $
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 RQMBURSE 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 THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF YSOUTHDSOR'S STREET CUT PER �vt 11
Signed: Date:
2 �Ae
Title: 998 D.L.#
to
PERMIT SHALL BE KEPT ON JOBSITE AT ALL Ti S,