HomeMy WebLinkAboutDriveway Street Cut Permits 171 Beelzebu Perm jdt, �,i 3354 To
wn wn of South Windsor, CT
Date' s 07/25/2002 Street Excavation Permit
Ex i rat i on')'0p)te �.i
Descrip:.
Applicant
Location
Name BOUTIN & SONS
Addr. 121 WINDSORVILLE R
BROAD BROOK CT 06 1 DRIVEWAY
Phone (860)623-2526
Applicant agrees f t sor the amount of bond
required and to rei s T th or any expenses
incurred by the Town r a epa n connection with this
permit and that a 1 '
pp '� a bide by the rules- and
regulations for perm tsaa. t uth Windsor'-s Street
Cut Permit Manual .
}
* * PERMIT Is LL TIMES.
Issued by
Date Completed Inspected By
I
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No Contractor BOUTIN & SONS
Location Address 121 WINDSORVILLE ROAD
Type Work DRIVEWAY BROAD BROOK CT 06016
No. (860)623-2526
Date I nsp Needed
Time Insp Needed ; �-g �i►'�
r•
Inspected By
1 S ! •
Work in Progress
k
7 Date
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 $outin & Sons Const . co. Phone No. 623-2526
Address of Firm_ 121 Windsorville Road Broad- Brook, Conn 0601 6
Location of proposed work_ 1 71 R e A 7 1 A h„h P n n rl
Describe fully nature of permit requested 1)rP_,9 driyPw y with 2ravPI ,r rarlP, rnl l and pa--ye
Starting date Approx.time for completion
Call before you dig no. 20023000700 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 $
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 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: 7/2 3/0 2
Date:
Title: SPcreta.ry D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
I � ,
b
� 1
4-4 °
A'
l
Quote Good for 66 Da
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract Permit
ONE YEAR GUARANTEE ON WORKMANSHIP&MATERIALS.
CRUD U U a 3 Do D / Q D 2,5
Date L�