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HomeMy WebLinkAboutDriveway Street Cut Permits 25 Deming St prffirt No. 3376 D td' 08/22/2002 Town of ,South Windsor, CT Street Excavation Permit Expiration Date 08/22/2003 Descrip; Applicant OVI N SLocation Name BOUTIN & SONS Addr. 121 WINDSORVILLE NG STREET BROAD BROOK CT 6 Phone (860)623-2526 o k DRIVEWAY oo Applicant agree h ew ndsor the amount of bond required and to re ' a ou for any expenses incurred by the To inta re in connection with this , permit and that ap h abide by the rules and regulations for pe u o South Windsor' s Street Cut Permit Manual . pP"II' �I f? 0 a e 1 * * PERMIT I" ALL TIMES.* Issued by Date , Comp 1 eted Inspected By ��..._i ./ TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3376 Contractor BOUTIN & SONS Location Address 121 WINDSORVILLE ROAD Type Work DRIVEWAY BROAD BROOK CT 06016 ne No. (860)623-2526 Date Insp Needed Time Insp Needed 3 r37 /'o� Inspected By g a Work in Progress S SOR- C t Cif- Date ) y� ©a- 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 Const. Co. Phone No. 623-2526 Address of Firm 121 Windsorville Road Broad Brook Conn 06016 Location of proposed work 25 D e m i n® Street Describe fully nature of permit requested- Dig out driveway and lawn area, putting in 6" of process gravel . grade roll and pave Starting date Approx.time for completion Call before you dig no. 20023400375 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 $ 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 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: Title: �� [�`�� D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES r I � y� + 25 . 00 permit fee l/UyG/�c.�►oC.� `� V Job Location: Description: —�D J,, L 6Mastercard Acceptedl, Quote Good for 60 Days. A' nd Special Attention: 1/2 Payment ,U�po/n Starting, ance Upon Completion. Contract `ram Permit n ` ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS.(p,�7 V Pres. Date CBUD /7�y 2