HomeMy WebLinkAboutDriveway Street Cut Permits 97 Rosemary Permit No. 2426 Town of South `r i nosor , CT
Dat;_ 05/05/ 1998 Street Excavation Permit
E:,o i r at ion Date 05/06/ 1999
Descrip:
Applicant Location
Name BOUTIN & SONS 07 ROSEMARY LANE
Addr . 121 WINDSORVILLE ROAD
BROAD BROOK CT 06016 Type of Work DRIVEWAY
Rhone ( 860 )623-2526
Applicant agrees to furrti sh ,,the: Town of South, 'Ali ndsor the amount of bond
required and to re �mburse � h ,`" owri �'r�f i�w;th W'tr+dsbr..'for any expenses
incurred by the Town for m �n enano�e +fir'' repair w}s rk ' i r1' connection with this
permit and that appl icant is� fami I�i'�r Vlt►� And -wi�1l ,abide by the rules and
regulations for-, permit`s as optVi ned. in the. 'Town `of� �So+�tt��; W i ndsor' s Street
Cut Perin i t Manual .
PERMIT TO ``8E KEPT ON "JOB 51 E AT ALL TIMES .
Issued by '� -- Title
Date Comp feted 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 Phone No. O(
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion
Call before you dig no. 22-I r) Traffic Services Control No.
d
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 Prop.size of cut
No.cuts
a 3'
Amt. of Deposit 8 by
p O Cash(1 Check#
4 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 RQIMSURSE 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:
Title:_L 4 ��,D D.L.N
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES