HomeMy WebLinkAboutDriveway Street Cut Permits 91 Dogwood L TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3612 CoatraChorC?UTIN,.:,& SONS
Location 0091 DOGWOOD LANE Address 121 WINDSORVILLE ROAD
Type Work DRIVEWAY $ROAD =BRQpK CT:;. 06016
Phon�0`No f86'9)623 ,2525;,
Date Insp Needed
Time Insp Needed _ — }me IzYsp 7777=—
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Inspected By _
Work in Progress -
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Input'" Date _ 3 --
Permit No. 3612 Town of South Windsor, CT
Date 10/10/2003 Street Excavation Permit
Expiration Date 10/09/2004
Descrip:
Applicant T,oCat`j on
Name BOUTIN & SONS 0091. DOGWO,.OD LANE
Addr. 121 WINDSORVITLE ROAD
BROAD BROOK CTfiype o i*V6rk DRIVEWAY
Phone (860)623-2526
Applicant agrees to fu:xxxaSh the I�au�sl o `Sol th Winds r th�,.'a.nount of bond
required and to reimburse,: the Te�wn bf SqutYt Waktds.or for any' expenses
incurred by the Tobin fpr 'ztt In enance or repair wQ In'eonn,.ection with this
permit and that app;lxcant is fhm�liar s�rxttt x�d wi;;ll abide by."'the rules and
regulations for permits :as .outlined an theTpwn..of Saut;h Windsor's Street
Cut Permit Manual.
* * PERMIT TO. BE KEP}T ON -TOB STTTE AT."A14L T.I'MES.
Issued bye -cti>�^ -- Title — — --
Date Completed _----- Inspected By
3� /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. 623-2526
Address of Firm to s Orvt 0 1 on
Location of proposed work 91 Dogwoodane
Describe fully nature of permit re uested t g out r t ve W
roll anc� 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
Amt. Due Town S
Applicant is responsible for contacting
the Police Dept.and C.S.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.
510/2/03
Signed:_4 /,�Z_ Date:
Title: �/�' Gl�Z /�.� D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
I ,
Off Avery Street + 25.00 permit fe(
Job Location:
n Description: h
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D9
)ngg,
0 11`Quote Good for 60 Days. ' • • -Special Attention: 1/2 Pay ent Upon Staalance Upon Completion. _
0 Contract Permit
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ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS. J
CBUD �-,L►�J V Date