HomeMy WebLinkAboutDriveway Street Cut Permits 618 Deming S TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4053 o r :.,,,.... .
Corgi t:x-a'c't B "SONS
Location 0618 DEMING STREET A'ddr 12
Type '? I.3 BDSO12'V:ZLLE ROAD
Work DRIVEWAY
3ROAD RElt3K,CT'>06016
Phox�� No (�50)623 2.526 ,,;
Date Insp Needed
Dade Zx�g
Time Insp Needed "" "'
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Inspected By
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Work in Progress
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♦ Permit No. 4053 Town of South Windsor, CT
Date 07/28/2005 Street Excavation Permit
Expiration Date 07/28/2006
Descrip:
Applicant Loc'a.tion
Name BOUTIN & SONS INQ STIZEET
Addr. 121 WINDSORVILLE RbAD;:
BROAD BROOK CT:06016 `: Types.faf Wox DRIVEWAY
Phone (860)623-2526 .`
Applicant agrees, toutl�sh the Tokr2} pbxth Windsvx the:::amunt of bond
required and to re'i`inburse:> the 'Town of. Sa t Y ndsor far wily expenses
incurred by the Tdwz1 for ;;ma�ntauaneer rZaa .,work 3x .:connectkon with this
permit and that applicants €amxlaar' wyh :`aid w`�-11 ab �ie by the rules and
regulations for perinita:as out ia..ned i . the ' qt�Rtitki' V7indS`or's Street
Cut Permit Manual.
Ai
* * PERMIT TO BE KE,1>T 'ON Job{ ' AT :'�}£L TIkEs
Issued by �' � � - w Title
---- �—
Date Completed ------------ ,.;.;:.::: ti"e d 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. Phone No. 623-2526
Address of Firm 121 Windsorvi le Road Broad rook, Conn 06016
Location of proposed work 618 D em i n Q Street
Describe fully nature of permit requested Complete dig out of driveway anEf iawn area,
add Qravel , grade, roll and pave.
Starting date Approx.time for completion
Call before you dig no. 20053001274 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
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee S
Amt. Due Town S
Applicant is.responsible for contacting
the Police Dept.and C.S.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 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: ,' ��i�/ 1���f`c'l Date: /
Title: �J E� Cai L f y r� D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
.;on Location: Off Rt . 30 or Buckland Road
.
Description:
rL' D
,300
r
e CL"
+� c `
Lp `L, t
s
Quote Good for 6�Days.
Special Attention: 1/2 Payment Upon Starting, Balance on Completion.
Contract 7N Permit }
ONE YEAR GUARANTEE ON WORKMANSHIP &/MATE IALS. Pres.
CBUD U ��� a 7T Date Q