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HomeMy WebLinkAboutDriveway Street Cut Permits 27 Chatham L TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3821 Location 0027 CHATHAM LANE Cont:;ra'ctor BOLtTTN.<;;& SONS Address ; 121 ,WxNDSORVILLE ROAD Type Work DRIVEWAY $ROAD :BROOK:.CT,:::'06016 ?:PhQne:NO (8150)62T-.2526.:;. Date Insp Needed --------- — Date xzxSpi+ aLL Time Insp Needed w -------- Time t n Inspected By Work in Progress v►"�� �,.,..����„,�� Input Date ��1 - Permit No. 3821 Town of South Windsor, CT Date 08/16/2004 Street Excavation Permit Expiration Date 08/16/2005 Descrip: Applicant Location Name BOUTIN & SONS t3€T27 CHATHPM LANE Addr. 121 WINDSORVILLE ROAD. , BROAD BROOK CT 06D16 Type a 'ATok IIRTVEGVAY Phone (860)623-2526 Applicant agrees to furnisFi the ;Towr� of South Wind tha amount of bond required and to reambUrse the=Town 4£ Soy;.th �3�1y.asor f© ahy; expenses incurred by the Town for manGenance or repair i cbn :ecton with this permit and that applicant is '€amxlaa xrityi axkfi 'wall abidey t'he rules and regulations for permits as outlined',':an tho TpWzs'.of S6u h W; sor s Street Cut Permit Manual. * * PERMIT TO BE XEPT Ob7 T4S 'SiTE' AT ALL TIMES. Issued by — -- :Tatle Date Completed ---- --- Inspected By y APPLICATI FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR • PUBLIC WORKS DEPARTMENT ��-� TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Boutin & Sons Const. Co. 623-2526 Name of Firm Phone No. Address of Firm 121 Windsorville Road Broad Brook, Conn 0601 Location of proposed work 27 ('ha therm T ane Describe fully nature of permit requested Strip existing;n driveway,way dig out sidep -ut in gravel grade., roll and payA Starting date Approx.time for completion Call before you dig no. 20043300406 Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of So Windsor two copies of separate drawing Pavement Cut Indicate North Prop.size of cut No.cuts Amt.of Deposit$ by O Cash O Check# Cut size after Perm. Patch No.Cuts Final Billing $ Amt.Due Payee $ Amt.Due Town $ Applicant is,responsible for contacting / the Police Dept.and C.B.Y.D. by dale 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.# ;t • PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES I 1 0 Job Location: ' "Description: Dig y 0 U 60 Quote Good for 60 Days. Special Attention: 1/2 P yment Upo`n'S arting, Balance Upon Completion. Contract I Permit ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. /5 '✓ `� CBUD Wl�Jc� Date 01 �r