HomeMy WebLinkAboutDriveway Street Cut Permits 79 Brian Roa PermM No. 3152
Dade .` 07/26/2001 Town. of South Windsor, CT
Street Excavation Permit
Expiration Date 07/25/2002
Descri6: CK#1403 FOR 3 PERMITS
Applicant
Location
Name BOUTIN & SONS
Addr. 121 WINDSORVILLE ROAD'_,,: 4079 BR"IAN ROAD
BROAD BROOK CT 06016 :"Type Q f� y,�prk DRIVEWAY__Phone (860)623-2526
Applicant agrees to i=urnish the Tpy�jh pf South Windsor the amount
required and to reimburse the f
'Town, Win dsor, for any expenses
of bond
incurred by the Town forinte`nartce Orgpa i r. rrk ill connection with this
permit and that appl icant, ami l �ar .w�tj� and abide by the rules and
�ti11 -
regulations for permits�as, out1ined: ih the Town; Qf South Windsor's Street
Cut Permit Manual .
* * PERMIT E `KEPT ON 'jO$ , SITE- AT ALL TIMES.
Issued by
Title _
Date Completed /z 2e b� -
Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3152 Contractor BOUTIN & SONS
Location Address 121 WINDSORVILLE ROAD
Type Work RIVEWAY �
BROAD BROOK CT 06016
Phone No. (860)623-2526
Date Insp Needed -Date, Insp.
Time Insp Needed ;T� e np
Inspected By �' --
Work in Progress
F`.
Input C/ i Date ,L3 ' y �—
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 Boutin & Sons ConSt. Co. Phone No. 623-2526
Address of Firm In SOPvl e oa roa rook, Conn
Location of proposed work 79 Br i a.n Road
Describe fully nature of permit requested_ Strip and widen driveway, grade, roll and 12a_ ve
Starting date Approx.time for completion
Call before you dig no. 20012902852 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
See
() Cash () Check#
Cut size after Perm. Patch
No. Cuts
Final Billing S
Amt. Due Payee S
Amt. Due Town S
Applicant is responsible for contacting
the Police Dept. and C.B.Y.D. by date
1 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: C Date: 7/19/01
Title: ��6`,0— r L� D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES