HomeMy WebLinkAboutDriveway Street Cut Permits 10 Carman Ro V '
r TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3768 Cont,r<a'C'tor BOUTIN" &:;;,.SONS
Location 0010 CARMAN ROAD Ad reriW:i ;INnsORVELLE ROAD
Type Work DRIVEWAY BFQAD BROOK CT 06016
Rhone No' (86A.'3623 "2526
Date Insp Needed
Time Insp Needed _--_— --- Time Inp
Inspected By — (
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Work in Progress ,j�
----- Inplxt <;Date
Permit No. 3768 Town of South Windsor, CT
Date 06 17/2004
/ Street Excavation Permit
Expiration Date 06/17/2005
Descrip:
Applicant Location
Name BOUTIN & SONS i�pl} CAIZMATd ROAD
Addr. 121 WINDSORVILLE: R01�D
BROAD BROOK CT p6016Wort DRIVEWAY
Phone (860)623-2526
Applicant agrees c fUMO§ :the Town 6 -iSl a ,h Windsas tl e< amount of bond
required and to reimburse thTf 5oukh Windsor xp penses
incurred by the ToW:n fori,MA1nt na=:G'q repair work ii';<connection with this
permit and that appicant' as familiar with<arrd tu: lY abde `by the rules and
regulations for perits:<>as outlined 7; .-thq '". :af.M : South Wi
m nclsgr's Street
Cut Permit Manual.
* * PERMIT T.O B$ KE'FT ON:;.� 8 , :T" A7 .`;3�LL TIMES
Issued by
Date Completedd7.:,:�;:,;,;:.:,:.:.,.:::::.:::,F:n:,s..Pec:t6!d' By \./
t APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC, WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
m
Name of Firm
Boutin & Sons Const. Co. 623-2526
Phone No.
Address of Firm In SOrvl e Road BroadBrook, Conn 06016
Location of proposed work 10 Carman Road
Describe fully nature of permit requested StriD Pxi cti n2o dri_ r� , Put in r,rnrocSgra4D--1,
grade, roll and pave
Starting date Approx.time for completion
Call before you dig no. 20042403071 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
()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
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 1 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: 6/14/04
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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Description:
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Quote Good for 60 Days.
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
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Contract ,' I Permit
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ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS.
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CBUD � j �t/ ,U�� ; Date
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