HomeMy WebLinkAboutDriveway Street Cut Permit 46 Andreis Tr Permit No. 3546 Town of South Windsor, CT
Date 07/17/2003 Street Excavation Permit
Expiration Date 07/16/2004 "
Descrip:
X.
Applicant LocaCign
Name BOUTIN & SONSBNDREIS. TRAM
Addr. 121 WINDSORVILLE RQAD
BROAD BROOK CT 060:16pe a€ Work-DRIVEWAY
Phone (860)623-2526
k k
Applicant agrees to furnzsh the. iow iCb Windsor the aMbunt of bond
required and to resmburs� the'. Town- e �Q t Yi sgr .ficsr any expenses
incurred by the Town €qx ma&-`.ttnance or repair wqr# zxr conitectfon with this
permit and that applacant 'asamilaisk .w�I� abide. by the rules and
regulations for permits as 6utlinede Mawr of S'o.uthIindsor's Street
Cut Permit Manual.
* * PERMIT TO BE' KEPT ON JOB SITE AT ALL::. TIMES.
Issued by yY `O I
------ ------------------
Date Completed Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3546 Cont..r...a'eto'r`'' OC7T'Z<N;:..;:&. SONS
Location 0046 ANDREIS TRAIL Address: i'.';; 121'>,WIN.DS6RUILLE ROAD
Type Work DRIVEWAY BROAb EIRQOK CT 06016
`Phone No 2526
Date Insp Needed Date L g4 _
Time Insp Needed
-- .
6'
Inspected By
it
Q �
4 .
Work in Progress _
XX
Input , #)ate
.APPLICATIOON FOR STREET EXCAVATION
N OF SOUTH WINDSOR PERMIT
PUBLIC TOWS DEPARTMENT
1540 SULLIVAN AVENUE
SOUTH WV25.00
DSOR, CT
FEE
Name of Firm
Address of Firm Phone No.
Location of proposed work An r e i s
rai
Describe fully nature of permit requested S t r i e x i s t i n
drivewa dress, ra e
Starting date ro an pave
Call before you dig no. Approx.time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing TO be fulled out b
Pavement �� Town of So.- Windsor
Indicate North -
i
Prop.size of cut _
No.cuts
Amt.of Deposit S by
f)Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee$
Applicant is responsible for contacting Amt. Due Town$
the Police Dept.and C.S.Y.D.
by date
I AGREE TQ FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REOU AND REIMBUROF
SE THE TOWN
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE
PERMIT AND THAT I A FAMILIAR WITH AND WILL ABIDE BY THE R EPA K IS
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. RULES AND REGULATIO SI FOR
OPERMITS AS OUTLINED NEDT N THE
Signed-
Date: 7/14/03
Title:
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Description: fUv
Quote Good for 60 Days.
Special Attention: 1/2 Payment ypo Starting, Balance Upon Completion.
Contract p��
Permit
ONE YEAR GUARANTEE ONORKMA HIP&MATERIALS.
CBUD W d' flu?
Date