HomeMy WebLinkAboutDriveway Street Cut Permits 629 Deming S .► TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3611 ContYao` or BOUTIN &. SONS
Location 0629 DEMING STREET Address 121 WNDSORVILLE ROAD
Type Work DRIVEWAY BROAD BROOK CT°>..06016
`Phone No '68C0)623=2526:.
Date Insp Needed Date Ins
Time Insp Needed
Inspected By _ U
Work in Progress
Input —�� ti Date
Permit No. 3611 Town of South Windsor, CT
Date 10/10/2003 Street Excavation Permit
Expiration Date 10/09/2004
Descrip:
Applicant location
Name BOUTIN & SONS OF29 DEMQNG STREET
Addr. 121 WINDSORVILIrE ROAD
BROAD BROOK CT 06.0.:16 Type cif Work D:RIV'EWAY
Phone (860)623-2526
Applicant agrees to €urnisix 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 fox maintenance or Yepa�r ;evork ii� Connectson with this
permit and that applicant is familiar With and >wil� abide b,y the rules and
regulations for permits as out lined, fri t,h Town€' of South Windsor's Street
Cut Permit Manual.
* * PERMIT :TO &E KEPT ON zbB :'5ITE AT ALL::.TIMES:
Issued by Title __—_---
Date Completed
P _-------- Inspected By —_—
APPLICATION FOR STREET EXCAVATION PERMIT alp)
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 Phpne Not n
Address of Firm121 In s0 V OK, @lTyt--�v�
Location of proposed work 629 Deming Street
Describe fully natureof permit requested esur ace top -dig out bottom widen a grave
grade, roll and pave
Starting date Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled Out by To" of Co. 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.B.Y.D. by date
I AGREE TQ 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.
10/2/03
Signed:_ �'�'"! � Date:
Title:- Se G/ e u D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Description: j 3 9,
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Quote Good for 60 Days.
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Special Attention: 1/2 Payment Upo Starting, Balance Upon Completion.
OContract Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. 1 Pre.,
CBUD Date
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