HomeMy WebLinkAboutDriveway Street Cut Permits 105 Farmstea TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 3756
Location Cont
raotbt $OVIIN SONS
Type Work DRIVEWAY Address
121 ;PINPSO'RV.ILLE ROAD
BROAb $R09K CT .06016
Phone Na 0),d. $ 2526.
Date Insp Needed
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Time Insp Needed
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Inspected By
Work in Progress
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Permit No. 3756 Town of South Windsor, CT
Date 06/14/2004 """" Street Excavation Permit
Expiration Date 06/14/2005
Descrip: CK# 1813 - 2 PERMITS
Applicant ;Zocataan
Name BOUTIN & SONS bvo ,FARMSTEiYT7.,..,DRLVE
Addr. 121 WINDSORVILLE ROAD
BROAD BROOK CT 06016 " Tyje o£ Sbrk DRIVBWAI.
Phone (860)623-2526
Applicant agrees to fttrnz. ii`the Trawl 0f,,;$o�ath Wind:sor.tlie: ami6Unt of bond
required and to reCnburse tho ,Town o€ nuhTi tadSox, fbr any`easpenses
incurred by the Town br majgipance"or repair wrsrk it eanne:ction with this
permit and that applicant as 'ami�# Mth..'aaaC� wt11 av'"3c�e kiy `tk�e rules and
regulations for permits as outlined '� h ,Towm,'of SSrtit T*t ;z d or's Street
Cut Permit Manual.
* * PERMIT TO BE KF,P AI,L T'IIr[ES.
Issued by
Date Completed .......A_—_--- Inspected B
APPLICATION FOR STREET EXCAVATION PERMIT �r6
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
P one(�
Address of Firm O�, C;v ii ii
Location of proposed work 105 Farmstead Road
Describe fully nature of permit requested_ Re rade eX1S17ing driveway, r0 11 an pave
Starting date Approx.time for completion
Call before you dig no. 20042300763 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
Applicant is responsible for contacting Amt. Due Town $
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.
6/3/04
Signed: Date:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
� Job Location:
OFF GRAHAMROAD AjEAD0,WROAD I / 2
i
Description:
/0'
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1� �L
Quote Good for 60 Days. . .
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract �An Permit
ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS. 'Ll
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CBUD Date
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