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TOWN OF SOUTH WINDSOR INSPECTION REPORT
1
Permit No Contra'.0 or BOIVIN CONSTRUCTION INC
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Locations
Addres.5 : P O:: 80#:'>337
Type Work DRIVEWAY L.UM,BIA CIT 0:623::.7,
Phone.No :870 8'9.83
Date Insp Needed _----_____-- DaY
Time Insp Needed Time I319
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Inspected By $E
Work in Progress _ � ° Q � � —
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Permit No. 4174 Town of South Windsor, CT
Date 04/06/2006 Street Excavation Permit
1
Expiration Date 04/06/2007
Descrip:
Applicant
" L�ac.ation
Name BOIVIN CONSTRUCTION 11TC (3pgT' CT�1:F�' QO:D I3RIV ..
Addr. P.O. BOX 337
COLUMBIA CT 06237 � e `.Ej WOV: DRIVEWAY
Phone (860)870-8983
Applicant agree. ;i: fu. sh,;the TsaYvn b' 5qufh Windsn t ie >ab- dtnt of bond
required and to re'rmburse the Town of S�tatYs'Y� xdsor fot''any `exerses
incurred by the Town f6r tr6ainten is q r >
tydxk Vt.'-ednnectidn with this
permit and that appl icant ;j fmi fir 'wf G13rYr3 ur3 '1 ak�ide by the rules and
regulations for permits as:; out3z'n,ed VA I,% Sottith: Wind'sor's Street
Cut Permit Manual.
i
* * PERMIT T;O BE KEPT Oil 3 AT AXL TIMES .`*
Issued by �it]e _
Date Completed <u's :eCted By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm le No.
Address of Firm U
Location of propos work C
Describe fully nature of permit requested
Staffing date Approx.time for completion
Call Before You Dig No. _ Traffic Services Control No.-4 4) _
Shaw sketch of proposed work or furnish To be filled cut by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No. cuts
Amt.of Deposit$ 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 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 SOUTH WINDSORAS ST CUT PERMIT UAL.
Signe
Date: e
Title: D.L.#:
PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc uL,t;, dl
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STRIP JOB ESTIMATE
oute 6•Columbia,CT 06237
-800-PAVE-145.228-4030
Date of Estimate: f)
Prepared by:
boivin construction Job Address:
Job Phone: Work Phone:P—7 ?— J �
Proposal Number: Type of Job: Sq.Ft.:
ESTIMATE S �
FOR: �A R o L
Specifications:
Strip driveway of asphalt,regrade using existing base
adding processed stone as follows:
❑ 0"-2" ❑ 2"-4" K4"-6"
❑ other
4a/l Cr
Pave u ' t �inssphalt as follows:i
G "in d coarse
❑ 1/2"binder )�class 2
1�U
�C
{ Special Nos: � Za U
) JP
{ Estimated Completion Date:
State Permit Required: ❑ yes no
{ Town Permit Required: yes ❑ no (� Q f p®
Taxable: ❑ yes no
Estimate Approved by: Total Bid:
a Signature for Quotation Release:
' This proposal may be withdrawn by Boivin Construction If not accepted within ten days.Workmanship and materials only are warranted for one year.