HomeMy WebLinkAboutDriveway Street Cut Permits 190 Benedict r }
Permit No.
Date 3703
05/10/2004 Town of South Windsor, CT
:.:;.....•:. x.:.v,. Street
Expiration Date Excavation Permit
Descri 05/10/2005 '>
Applicant
yNl <;
:`
Nam �a < b
e BOUT �.)<,sx�:"��r�'- `:r°` n
IN & SONS 3,. '�
Addr. 121 3fi
WINDSORVILLE' ROAD Bi71Ct DRTk7E
BROAD
BROOK
Phone
8( 6 0
2 3-
5 2 :.�6
a3:
s<
:
A1 i
pP cant
f r
r
L�
e ?� t h uir efTr
required o,
a w an
d t o :.�:..
ttih Wind'
incurred ox .'r _ <:ror,.:.a�1e.„argon
permiteandy the Town for m4l,n na ?ki sQr f f , e pensesof bond
that appl3c. at1?:a ::<;w, �C': : ; .ct" Gn with
regulations z .h.. CQk3i1 this
for permits as 'b:ut; >:<f. Y;.' d. ce b::::><:,..
Cut Permit
Manual. ... :1Q ':a`£i: ° z..: ..,::.;.:; the rules and
ub 'Minds. r s Street
PERMIT TOI�;-Bff
Issued by
Date Completed :.:...<> <-- _ --
— ---
Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 37
Location a Contrg;.to 'f-SOUPIN SONS
Type Work Aradr'es�.. 321INISOTLLE ROAD
�IEWAY �r
B120j B:-OO.I€' CT``zz9..6016
Date Ins /
p Needed • £ � rh �
'------ Dade a�w-f-------
Time Insp Needed
rf:
-----------
Inspected
Y o_
�xz
N
d:ff. rf
Wo
rk
r k
ham.
in
g ss P r
0 r e---
-------- ii•' ...........
.. C
---------------
-----------------------...r
In73 Z :3--
ate -_— ———_1
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS
DEPARTMENT
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
m
Name of Firm
Boutin & Sons Const. Co. 623-2526
Phone No.
Address of Firm 121 Windsorville Road Broad rook, Conn 06016
Location of proposed work 190 Benedict t r e e t
Describe fully nature of permit requested Strip existing driveway add grave , grade, roIE—
and pave
Starting date Approx.time for completion
Call before you dig no. 20041902998 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
1
Indicate North Prop.size of cut
No. cuts
Amt. of Deposit S by
() Cash()Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee $
Amt. Due Town S
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. b
Y date
-
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SOUTH WJNDSOR 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:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Description: v2A --4�-4'04.
f
o
nag �
r
I
Quote Good for 60 Days. /
Special Attention: 1/2 Payment U n Starting, Balance Upon Completion.
Permit
Contract a
P &MATERIALS.
WORKMANSHIP ONE YEAR GUARANTEE ON S��/
Date f
CBUD U
Of