HomeMy WebLinkAboutDriveway Street Cut Permits 89 Farmstead TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3824 •_, p
Location 0089 FARMSTEAD DRIVE Contractor BOUTIN &; SONS
Addr"
Type Work DRIVEWAY S 121 W.INDSORVILLE ROAD
BROAD 13ROPK CT 06016
Phone No. (860)623-.2.528
Date Insp Needed /I
Dat e - _ _
Time Insp Needed
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Inspected By ,
Work in Progress
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' Permit No. 3824 Town of South Windsor, CT
Date 08/16/2004 Street Excavation Permit
Expiration Date 08/16/2005
Descrip:
Applicant liocaton
Name BOUTIN & SONS 0.089 FARMSTEAD, DRIVE
Addr. 121 WINDSORVILLE ROAD"
BROAD BROOK CT06016 Type 0f Wo'rk,.A DRIVEWAY
Phone (860)623-2526
Applicant agrees to furnish the Towel of South Windsor the amount of bond
required and to reimbursel:. the Town 6 SortW Windsor fpr any expenses
incurred by the Town. for ka1mtenance `or repair work in ,on ect.ion with this
permit and that applicant'<ss €am�laar: with and wxll abide by' the rules and
regulations for permits as outlined i:n th.6T.— of South W.in.dsor's Street
Cut Permit Manual.
* * PERMIT TO.$E XEPT ON JOB SITE AT. ALL 'TIMES.
Issued by ------ -- —� T tie
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Date Completed
Inspected By
—, �--------------- �- �.
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR `f
•,a PUBLIC WORKS DEPARTMENT 0
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Boutin & Sons Const. Co. 623-2526
Name of Firm Phone No.
Address of Firm 121 Windsorville Road Broad Brook, Conn 06016i
Location of proposed work arms ea rive
Describe fully nature of permit requested rip existing driveway dress wl process gray ,
grade, roll and pave
Starting date Approx.time for completion
Call before you dig no. ZUU4JJU1G424Traffic 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
C) Cash() 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 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: Date: / Z
Title: D.L.#i
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Description:
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30
Quote Good for y Days.
Special Attention: 1/2 Payment Upo tarting, Balance Upon Corn etion.
Contract Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & ATERIALS. G�
CBUD �,d
Date