HomeMy WebLinkAboutDriveway Street Cut Permits 318 Felt Roa TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3@9 Contra & SONS
Location ressk 121 r.W,,I ROAD
Type Work D `: ' `JBS2o OQF, CT<:;,06016
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Permit No. 3893 Town of South Windsor, CT
Date 12/06/2004 ... Street Excavation Permit
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Expiration Date 12/06/2005 `,{ ,» '`' ^?•:.,
Descrip:
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Applicant
Na
me BOUTIN
SONS .rz.
Addr. 121 WINDSORVILL; :RQAD�f
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AD BRO
OK CT Vs..<0
Phone (860)623-2526 "' z ,. q%•
Applicant agree g ree� '^to f;uas%' ,h.. theTc.w`� ,.ti`�<= �.`:�h Wins`:oY�q`ta�e"a�tnes'unt of bond
required and to ream}zay eR
se.',;,. i '<<T4ae1 .`:;?' r�' "'•:a.y ''` or
Onses
incurred by the To na , o 5 "'
'` 43inectiybn with this
permit and that e rules and
regulations for persx,ts asu •xlcl ' . t y'ind 'or's Street
Cut Permit 'Manual.
* * PERMIT TC) E$.., E•P,�'-01
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Issued by �Y --------------
Date Completed Inspected By —
9' APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
.� PUBLIC WORKS DEPARTMENT 3 E�t 3
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Phone No.
Name of Firm
Boutin & Sons Const. Co. 623-2526
Address of Firm 121 Windsorvi lle Road Broad Brook, Conn 06016
Location of proposed work 318 Veit Koacl. -
Describe fully nature of permit requested Regrade existing driveway, roll anil pave
Starting date Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North
Prop.size of cut
No.cuts
Amt.of Deposit S by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing$
Amt.Due Payee 8
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.
11/30/04
Signed: Date:
Title: G' D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Description:
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Quote Good for 60 Days.
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completio do ,
Contract
�— Permit
ONE YEAR GUARANTEE ON WORKMANSHIP& MA ERIALS.
CBUD 1 P
Date
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