HomeMy WebLinkAboutDriveway Street Cut Permits 41 Bramblebr (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2952 Contractor BOUTIN & SONS
Location 0041 BRAMBLEBRAE Address 121 WINDSORVILLE ROAD
Type Work DRIVEWAY BROAD BROOK CT 06016
Phone ,No. (860)623�-2526
Date Insp Needed °
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Time Insp Needed f "�im3p
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Inspected By :
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Work in Progress
Input — Date
Permit No. 2952 Town of South Windsor, CT
Date 04/20/2000 Street Excavation Permit
Expiration Date 04/20/2001
Descrip:
Applicant Location
Name BOUTIN & SONS
1 }41j BAAM3LEBRAE
Addr. 121 WINDSORVILLE ROAD
BROAD BROOK CT 060 Work. DRIVEWAY
Phone (860 )623-2526
Applicant agrees iio,,; f urh fah �"t of Se60th' ;WJ,.ndsor the amount of bond
required and to reimt u sir Town' of - o6th"4i"� for any expenses
incurred by the Town _far Mh ni�e6 4r sir rspai.r work h connection with this
permit and that appl *can i; is farmli;4r WA th and' .wi11 abide by the rules and
regulations for permits t .nd in the` Town of South Windsor's Street
Cut Permit Manual .
* , P RMIT 1d K,1*PT oN 'Jos , SI7� A`---,-ALL TIMES.
Issued by �( �} .Title
Date Completed __ °Inspected By
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APPLICATION
OWON OF SOUTEXCAVATION
WINDSOR N PERMIT
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm one No. C6 aR
Address of Firm
Location of proposed work 'e
Describe fully nature of permit requested
Starting date - 2/- C5 .9. Approx.time for completion
Call before you dig no. Z 0 3,41 Z.. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
t
+f Amt.of Deposit$ by
O Cash(1 Check M
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1 (! Cut size after Perm. Patch
if
No.Cuts
Final Billing $
Amt. Due Payee $
Amt. Due Town $
Applicant is responsible for contacting
the Police Dept. and C.S.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO RQIMBURSE 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.
V�14
Signed Date:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES