HomeMy WebLinkAboutDriveway Street Cut Permits 70 Scantic M Permit No. -w 3210 Town of South Windsor, CT
Date 10/09/2001 Street Excavation Permit
Expiration Date 10/09/2002
Descrip;
Applicant Location
Name BOUTIN & SONS ,
Addr. 121 WINDSORVILLE ROAD..' � ` R
BROAD BROOK CT 06016 �� q, f'w{�a pPIVEWAY
Phone (860)623-2526
Applicant agrees t4 fur,n$� ,
� the, � t�f:`5 t,,,,, dsor the amount of bond
required and to re i mbo rse :-t ow 4 uth W�"ew'sor;,far any expenses
i ncu r red by the Town 1=or� maenan 0r repa i r tc�F�k irt connection with this
permit and that app1i ari �1 ',anfibide by the rules and
regulations for permit$ 4s 1 �r1ed 1rr9t tf,. Squth Windsor's Street
Cut Permit Manual .
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* * PERMIT TO 'BEGET , J-CS8 Sl1E 'A"f ALL TIMES.
Issued by z'
Date Completed ZIJJ }
C Inspected 8y � � -�
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 Boutin & Sons Cons t . Co. 623-2526
Phone No.
Address of Firm_ 121 Windsorville Road Broad Brook Conn 06016
Location of proposed work 70 S(--antir M adow Road
Describe fully nature of permit requested Strip Fxisting )Driveway put in gravel grade
roll and pave
Starting date Approx.time for completion
Call before you dig no._20014000315 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 Prop. size of cut
No. cuts
Amt. of Deposit S by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing S
Amt. Due Payee S
Amt. Due Town S
Applicant is responsible for contacting
the Police Dept. and C.S.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE 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.
Date:
Signed: L 10/01/01
g �c.G �
Title: D.L.#
-- PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
mcscription:
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Quote Good for 60 Days. �ISA and Mastercard Accepted',
Special Attention: 1/2 Payment Upon Starti fig, Balancebpon Comple ion.
Contract V Permit
ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS. /J Pres.
CBUD �� ) / D D O ✓? Date