HomeMy WebLinkAboutDriveway Street Cut Permits 585 Felt Roa TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3864 ContrCjT-1—M4. SONS
Location C)'Sr$�a'. Ad8re .; +�jl21 J:�NDSOkF�jLLE ROAD
Type Work DRIVEWAY ` BROAD' $}tOO CT'"fl6016
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46 Permit No. 3864
Town of South Windsor, CT
Date 10/05/2004 Street Excavation Permit
Expiration Date 10/05/2005
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Applicantu.
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Name BOUTIN & SONS �BF� LT I3pPD
Addr. 121 WINDSORVILLW"ROAD Y
BROAD BROOK CT 06aO '
Phone (860)623-2526
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Applicant agreed . :cs:f f-u.'. 'JaA'.<the:>::: a"'"' ::.'
k�.. �vr ;,cT ; ou h Win.0sdt% e:-afariiount of bond
required and to rel S. 'die own of. SR Elr% 3r-Wsor :yak an' exp4ises
incurred by the Towjl, x ga �ir r�3 irk �1 �cir�hection with this
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permit and that appicatfmiTi � wkxrYc^l uts`1� 13 by the rules and
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regulations for perty �n �i3y�t3y 3 � SoaitY� WinCs�3rIs Street
Cut Permit Manual. A.
* * PERMIT i�O BE KEPT OIT L� 1�7� AI,'L F7MES
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Issued by it
'it��e.
Date Completed """"�.:,:
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC TOWN DEPARTMENT
1540 SULLIVAN AVENUE I
SOUTH WIDSOR, CT
FEE $25.00
Name of Firm
Boutin & Sons Const . Co. Phone No. 623-2526
Address of Firm 121 Windsorvi lle Road Broad Brook, Conn 06016
Location of proposed work 585 Felt Road
Describe fully nature of permit requested Dress. existing r iveway, gra e, roll and pave
Starting date Approx.time for completion
Call before you dig no. 20043902869 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing$
Amt.Due Payee$
Amt.Due Town$
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:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Job Location:. // �
Description: r'`�v��vf , f1J17
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Quote Good for 60 Days, oZ
Special Attention:
1/2 Payment Upon S
ding, Bala
Contract a Upon Completion. '
ONE YEAR GUARANTEE O Permit
N WORKMANSHIP&
CBUD MATERIALS.
Date Pres.
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