HomeMy WebLinkAboutDriveway Street Cut Permits 746 Avery St Permit No. 3550 Town of South Windsor, CT
Date 07/21/2003 Street Excavation Permit
Expiration Date 07/20/2004
Descrip:
Applicant o Lcaton
Name BOUTIN & SONS
0746 ER
ST12EEi
Addr. 121 WINDSORVILTA RoAA
BROAD BROOK CT 06i316 T ae of Tork DRIVEWAY
Phone (860)623-2526 �:...r:.
Applicant agrees to,.fixrnash the T iyrrilzth Windsor the amount of bond
required and to reimburse th Town: o �
h�YxFor far any expbnses
+G:rY
incurred by the Town for malt nance or repair wox1 yr� �onnectxon with this
permit and that appla'.cant as faftl a t wall cxbide -by t'he rules and
regulations for permits as butt' 'a the Doty of South,Windsor's Street
Cut Permit Manual.
* * PERMIT TO $E KEPT OI7 JOH- SITE A7 ATrI.; TTMES.
ii�/�!� C
Issued by _--- f f l £itle
Date Completed -------- Inspected By � Q
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No, 3550
Location 0746 AVERY STREET Con:tractor_ BOUTIN"'5r;.;,SONS
Addxess Type Work DRIVEWAY 121 WIItTpSORVLLE ROAD
8RO1�A Bf2O0K _CT 46016
Ph
one:. (8& )623 :'25.26
Date Insp Needed
------------- T_ Date Ines
a
Time Insp Needed
------------- Time III,fPr
Inspected By
Work in Progress
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Input Datey--�--��—1
APPLICATION FOR STREET EXCAVATION PERMIT
j TOWN OF SOUTH WINDSOR
PUBLIC, WI,OOK S DEPARTMENT
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm
Boutin & Sons Const. Co. 623-2526
Phone No.
Address of Firm 121 Windsorvi l le Road Broad Brook Conn UbU16
Location of proposed work_ dlg out existing drivewa , put in gravel, gra e
roll and Dave
Describe fully nature of permit requested Avery, t r e e t
Starting date Approx.time for completion
Call before you dig no. 20032902083 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop size of cut
No.cuts
Amt. of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Applicant is responsible for contacting Amt.Due Town$
the Police Dept.and C.B.Y.D. by date
I AGREE TQ 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.
Signed: Date: 7/17/0 3
Title Se- G✓�/��j
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
nDescription:
7� " ply
vet
i
j Quote Good for 60 Days.
Special Attention: 1/2 Payment Upon arting, Balance Upon Completion.
0 Contract
Permit
ONE YEAR GUARANTEE ON WORKMANSHIP&MATERIALS.
CBUD ( � & .
Date
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