HomeMy WebLinkAboutDriveway Street Cut Permits 93 Stonefiel Permit No. 3087 L"3 Town of South dsor, CT
Date 04/18/2001 Street Excavation Permit
Expiration Date 04/18/2002
Descrip:
Applicant Location
Name BOUTIN & SONS �.�.
Addr. 121 WINDSORVILLE RbAO,
BROAD BROOK CT 06016 Type of WorkcDRIVEWAY
Phone (860)623-2626
Applicant agrees f . t "T" Caf S60t l idsor the amount of bond
required and to reimourse ,,;,the, h Wit #spr -for any expenses
incurred by the Town far. MI .Int rk 'in connection with this
permit and that appl is ami far ttta d � abide by the rules and
regulations for permits` 'as��� Cr �ty� r ;of "South Windsor's Street
Cut Permit Manual .
* 4RMIT TO s ,' KEPT, ,�� SITE, AT ALL TI
MES.,�-,�, �
.Issued b � �`� � .�'� .
Date Complet Inspected B _
Y
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE ✓�
SOUTH WINDSOR, CT (��
FEE $25.00 0
Name of Firm Boutin & Sons Const . Co. Phone No. 623-2526
Address of Firm 121 Windsorvi 1 1 e Road Broad Brook ot- ntinl 6
Location of proposed work SQL-mac t e n e f i e 1 d T-'-
ail
Describe fully nature of permit requested Pik gat bettem1 eL-tien e f ve,
Starting date Approx. time for completion
Call before you dig no. 209116'904.22 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 ��cc y Pavement Cut
Indicate North / Prop, size of cut
a� No. cuts
t
� r _ Amt. of Deposit 6 by
O Cash O Check#
�Iy
I Cut size after Perm. Patch
No. Cuts
Final Billing S
Cvnc�e Fe- Amt. Due Payee S
Amt. Due Town 8
Applicant is responsible for ntacting
the Police Dept. and C.B.Y. . by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO RF,I.MBURSE 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 SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
SiDate:gn ed: � /.��.(iJ�
Title: Secretary
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES