HomeMy WebLinkAboutDriveway Street Cut Permits 675 Clark St TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3117
Location Contractor BOUTIN & SONS
'' '16,�M;: . S IE
Type Work DRIVEWAY Address 121 WINDSORVILLE ROAD
BROAD BROOK CT 06016
Phone No. (860)623-2526
Date Insp Needed Date hap
Time Insp Needed T� � - np,
Inspected By
Work in Progress
Input Date
Permjt;No. 3117 Town of South Windsor, CT
Date' 05/21/2001 Street Excavation Permit
Ex ration Date 05/21/2002
Descrip: '-CK1346 FOR THREE PERMITS
_ Applicant Location
Name BOUTIN & SONS
',01675. LARK STREET
Addr. 121 WINDSORVILLE ROAD
BROAD BROOK CT 06016 Type' o,f• Work DRIVEWAY
Phone (860)623--2526
Applicant agrees to f rnis l:-thy_`, fi south' "WVindsor the amount of bond
required and to reimburse the°Town `df. Bo tfi° Jon or'�_�for any expenses
incurred by the Town for. r et, Imt nan�� mow. ��pair� irk�:irt connection with this
permit and that applicant .Ts Ami1 ,-ar w th a4.w411 abide by the rules and
regulations for permits at,,'I .Town. South Windsor's Street
Cut Permit Manual . ..
PPEERMMIIITT TO 19E 'CEP' ;gyp ,BITE AT ALL TIMES.
Issued by �� `yC-� Title
Date Completed Inspected By
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 Cons t . co. 623-2526
Phone No.
Address of Firm 121 Win sorvi e Road Broa Brook, Ct 0601
Location of proposed work 675 Clark Street
Describe fully nature of permit requested Widen Areas of driveway then terre tex
Starting date Approx.time for completion
Call before you dig no. 2001200315 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 5 by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee $
Amt. Due Town $
Applicant is responsible for contacting
the Police Dept. and C.S.Y.D. by date
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: Date: 5/15/01
Title: Secretary
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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Quote Good for 60 Days.
ME,
Special Attention: 1/2 Payment Upon Starting, Balle, U:)Fn Completion.
Contract P. rmit 1 vim`- 4
ONE YEAR GUARANTEE ON WORKMANSHIP &MbTER LS. Pres.
CBUD Date