HomeMy WebLinkAboutDriveway Street Cut Permits 637 Deming S TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No.
3778
Location 0637 DEMING STREET Con taet
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Type Work DRIVEWAY SONS
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Permit No. 3778 Town of South Windsor, CT
Date 07/01/2004 Street Excavation Permit
Expiration Date 07/01/2005
Descrip: CK 1824 $75.00 FOR'-;s
Applicant
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Name BOUTIN & SONS 0 9 DEMING STREET..
Addr. 121 WINDSORVILLi PZ(a-ADi'
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BROAD BROOK CT i06p�6 �3' e � �� LYX2x�7E�P1I,
Phone (860)623-2526
Applicant agrees: to fuxnsh-the Tpv .srf Stluti Wind`sox, tk1e; amoilnt of bond
required and to rein :Ur"'5
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incu
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ed by the
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x�p'a 'f'»tie3k ;::3nzi' '7n 'ction with this
permit and that a 1'icanMt ` 'F.s :::
PP wiz >` :r>..ur"' :::>> '" ;::
. .::#;:: $ �, byC 'e rules and
regulations for permits as.. Cut'Z:iri'ed;> ; ;:<:<;.=s :a`,.........,:;.;.
ixi the Toxj tlf South Wni3stlr's Street
Cut Permit Manual.
* * PERMIT TO "=BE.;k': ...T Ohl >cYtaB..;, TTL t1` AFaL::.T3MPsS.
Issued b %
Y
Date Completed Inspec d -i
----------------- te BY .� s :_ ,.�f
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
1540 SULLIVANAVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Const. Co. 623-2526
Phone No.
Address of Firm 121 Wina-s-o-r—vi-Ele--R—oa-ff Broa 06016
Location of proposed work` 637 Deming Street
Describe fully nature of permit requested Strip existing driveway, dress with gravel, grade,
roll and pave
Starting date Approx.time for completion
Cali before you dig no. 20042700338 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town Of So WinCISOr
two copies of separate drawing Pavement Cut '
Indicate North Prop.size of Girt
No.cuts
Amt.of Deposit$ by
.` O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing$
l ..
�;;.. Amt.Due Payee $
�L Amt.Due Town $
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 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: J e G l6 a i
D.L.#
RAT '
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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10
i
Quote Good for 60 Days. iil`iYriti
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion. _
Contract ��� Permit
ONE YEAR GUARANTEE ON WORKMANSHIP&MATERIALS.
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CBUD � t ` o J J Date
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