HomeMy WebLinkAboutDriveway Street Cut Permits 548 Foster S TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 15 Contractor BOUTIN & SONS
Type Work DRIVEWAY
Location Address 121 WINDSORVILLE ROAD
BROAD BROOK CT 06016
Phone No. (860)623-2526
Date Insp Needed 0 /
Time Insp Needed
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Inspected By
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Work in Progress '
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Date C/'(9 -
Permi t' No. 3415 Town of South Windsor, CT
Date' -471 1Q/. /2002 Street Excavation Permit
Exp`ii ai tion Date 10/09/2003
Descrip:
Applicant Location
Name BOUTIN & SONS "54' �O ER STREET
Addr. 121 WINDSORVILLE RO
BROAD BROOK CT 06 f DRIVEWAY
Phone (860)62.3-2526 {
Applicant agrees f i sor the amount of bond
required and to rei bab or any expenses
incurred by the Tow a rep n connection with this
permit and that app i fam' h a 1 bide by the rules and
regulations for per T uth Windsor's Street
Cut Permit Manual .
Y
* * PERMIT LL TIMES. '*
Issued by f= NA 1 , �. ►G.
Date Completed spected By
• APPLICATIONVFOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
r PUBLIC WORKS DEPARTMENT M� fi
TOWN HALL
1540 SULLIVAN AVENUE ,,
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm erI I v Phone o.
Address of Firm
Location of proposed work
Describe fully nature of permit requested
Starting date Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled Out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
` Amt.of Deposit S by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
<:5—> Final Billing$
8 i Amt. Due Payee $
Applicant is responsible for ontacting Amt. Due Town $
the Police Dept.and C.B. 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.
Signed:
Date:
Title:
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES