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HomeMy WebLinkAboutDriveway Street Cut Permits 25 Dogwood L ` TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3639 Cont.radt..br""B.0.: SONS Location 0025 DOGWOOD LANE Address 121 .:yTINL1SO '�l:ILLE ROAD Type Work DRIVEWAY „5ROAD BRQOK CT :,06016 Rhone YaO ('{30) 6B3 2526> Date Insp Needed ----------- DaCe::Insp Time Insp Needed ti — --------- Inspected By c �' s Work in Progress p Input '^ J Date __�— Permit No. 3639 Town of South Windsor, CT ` Date 11/25/2003 Street Excavation Permit Expiration Date 11/24/2004 Descrip: Applicant Location Name BOUTIN & SONS025 Dp'CW(�pD;LAE Addr, 121 WINDSORVILLE ROAD BROAD BROOK CT 060;16 ., "' T ype.cff, Work;;DR�S7 WAY ji Phone (860)623-2526 Applicant agrees Go: furnash then �c�wn t7 South Wiii,lsc3 - tk�e 8mpunt of bond required and to rembufse the Town of 'Tdsor for' any expenses incurred by the Town :.for Maiii enonb: or 'rep ix work s connection with this permit and that applic, t- r witkx a: A., by the rules and regulations for permits as o tliite:d sus. the of. S©ut1J'W'int3sor's Street Cut Permit Manual * * PERMIT TO BE: KEPT 'ON r3pp<. AT ALi TIMES;; 'YVI r� Issued by Title. Date Completed ----------------- :>;:.;::::,..><;Lr.ap:e `t'e d By •, APPLICATION FOR STREET EXCAVATION PERMIT PUBLIC- OF SOUTH WINDSOR UBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE 25.00 Name of Firm Boutin & Sons Const . Co. Ph 623-2526 a Address of Firm lri sorvl e Oa roa r007,No Location of proposed work 25 Dogwood Lane Describe fully nature of permit requested S trip e x i s t i n g driveway andprocess gravel, grade, ro1I 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 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 S Applicant is responsible for contacting Amt. Due Town the Police Dept.and C.B.Y.D. by date I AGREE T.0 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. 11/19/02 Signed: Date: Title Se�` D.L.# PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES Job Location: Description: 1 l Quote Good for 60 Days. Special Attention: 1/2 Payment Upon tarting, Balance Upon Completion. Contract Permit ONE YEAR GUARANTEEf ON WORKMANSHIP & MATERIALS. CBUD0��� d �� Date �`