HomeMy WebLinkAboutDriveway Street Cut Permits 54 Orchard H Perm"�t No. 2480 Town of South Windsor, CT
Date 08/07/1998 Street Excavation Permit
Expiration Date 08/07/1999
Descrip:
Applicant
Location
Name BOUTIN & SONS e D �'` RRD HILL DRI
Addr. 121 WINDSORVILLE ROAD a,
BROAD BROOK CT 06016,11
<.DRIVEWAY
Phone (860)623-2526
Applicant agrees tarfb rrt7" �1;Ji ,Vi nd or the amount of bond
required and to reimbwrle T-0wn �rS d` rrd;r any expenses
incurred by the Town for;' �� pa � connection with this
permit and that app 1 i an. ;fame"1 an ti de by the ru 1 es and
regulations for permilWs � s1 !� wg owrth Windsor's Street
Cut Permit Manual . T °
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* * WERMIT TflEPT;� '�` �TE TdLL TIMES.*
Issued bye
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Date Comp le � 're, B
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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 Firm Y, xil
Location of proposed work r r
Describe fully nature of permit requested o
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 b,X Town 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#
Cut size after Perm. Patch
No. Cuts
Final Billing S
} Amt. Due Payee $
I Amt. Due Town $
Applicant is responsible f 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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF OUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Ynt "1
Date:4, 1, ]/V��
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PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES '
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