HomeMy WebLinkAboutDriveway Street Cut Permits 109 Quarry B Permit No. 3034 Town of SouLh Windsor, CT
Date )0/04/2000 Street Excavation Permit
Expiration Date 10/04/2001
Descrip:
App'1 i cant; Loc,at 7 On
Jame BOOTIN, & SCNS 0109 QUARRY e3ROOK CARP ���
Addr .. , 121 WINDSORVILLE ROAD
t�'
BROAD BROOK CT 06016 Type of Worm DRIV'WA`Y
Phone (860)623-2526
Applicant agrees to .furnish the Town of South Windsor the amount of bond
required and to reimourse the Town of ,South Windsor for any expenses
incurred by the Town :for maintenance or' repair work in connection with this
permit and that applicant i's 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 .
* PERMIT TC" BE ;KEPT ON JOB SILTE AT ALL TIMES .
. --
Issued by Title
Date C.ompl-et.ed ' _ i� - _ _ Inspected By
x APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN MALL
1.540 SULLIVAN AVENUE
_SOUTH WINDSOk CT
FEE $25.00
Name of Firm Boutin & Sons Const: Co. 623-2526
Address of Firm 121 iiJinasorvi le Roa Phonelo.
roa Brow Con..
Location of proposed work 109 uarr Brook. Drive
Describe fully nature of permit requested Str.12 riveway ress WJ.Ln. pr ces e
Starting date Approx.time for compietion
Ca11 Before You Dig No. 200 D—5 13 Traffic services control No.
Show sketch of proposed work or furnish
two copies of separate drawing To
by Town of South Windsor
CQ a 2, f 1 Pav-men rut:
Indicate North
Prop.size of cut
20 Na.cuts
Amt.of Deposit$ by
Cash Check .
i
2 Z 0 Cut size after Perm. Patch .
No. Cuts
b Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for co by----the Police De :and C.B.Y.D. date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH T OF
HIS
PERMIT ANQ 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: 10/2/00
Title: Secretary
D.L.#:
PERMIT.SHALL BE KEPT ON 300SITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc