HomeMy WebLinkAboutDriveway Street Cut Permits 17 Carman Ro a
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2708 rq-7 Contractor BOUTIN & SONS
Location 0017 CARMAN ROAD Address 121 WINDSORVILLE ROAD
Type Work DRIVEWAY BROAD BROOK CT 06016
Phone No. (860)623-2526
Date Insp Needed D te - Insp..` .
Time Insp Needed Ti me, Insp
Inspected By
Work in Progress
Input .. ALk
Date
PWwn`i t No. 2708 Town of South Windsor, CT
Date 06/04/1999 Street Excavation Permit
Expiration Date 06/03/2000
Descrip:
Applicant Location
Name BOUTIN & SONS , 0D-7 �CARMAN ROAD
Addr. 121 WINDSORVILLE ROAD
BROAD BROOK CT 0601.E , gyp 6 Wdek DRIVEWAY
Phone (860)623-252E
r
Applicant agrees to gfuri � h or the amount of bond
required and to reimb r e e ow o h ° *W". r f4)r any expenses
incurred by the Town Ef� ifien� �! � pa ,� connection with this
permit and that appl ia'ri� s; am � �� � ani >f � 1� ai de by the rules and
regulations for permis ' t �� a�Tot oth Windsor's Street
Cut Permit Manual .
PERMIT to ���� 1��P� � � h���" A�"�� L TIMES.
Issued by , Jam• Fr(ZJJA Ti t
73V 'I
Date Completed _7 Zispected B�
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Pho No.
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig No. 9 Z Traffic Services Control No.
Show sketch of proposed work;or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
{)Cash{)Check#
Cut size after Perm. Patch
J (�
No. Cuts
Final Billing$
a Amt. Due Payee$ _
Amt. Due Town$
Applicant is responsible for contacting by date
the Police Dept.and C.B.Y.D.
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 UTH WINDSORIS STREET CUT PERMIT MANUAL.
Signed• Date:_
-61
Title: D.L.#•
V
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms Permits\Street Excavatiost PQrroit dnc-----------.--.----------- --------------------.-----------��.---.-