HomeMy WebLinkAboutDriveway Street Cut Permits 811 Graham R TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3692 Con,t.ractor BOUTT'ni' &.:..;SONS
Location 0811 GRAHAM ROAD ;Addre, :a ::<, 121.'".410DS ZLLE ROAD
Type Work DRIVEWAY gQAD BROOR CV--.06016
Pho..rre N6,.(8D)623, 2526
Date Insp Needed Date Tta
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Time Insp Needed --------- _'_ me Yj ie
Inspected Byy�jJ4y +hp
Work in Progress
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Permit No. 3692 Town of South Windsor, CT
Date 04/30/2004 Street Excavation Permit
Expiration Date 04/30/2005
Descrip:
Applicant Lo.pation
Name BOUTIN & SONS AHAPf
Addr. 121 WINDSORVILL. ROAD,,,.,:
0016BROAD BROOK CT ' Wa DRICWAY
Phone (860) 623-2526
Applicant agrees to furria.sh.'th� T�Ca2? ofpt�,th Widsq the>:a'mount of bond
required and to reimburse the 'Town of. Sout€� .#xidsordr''ar y"eipnses
incurred by the TOWn;,for maixtersar�ce rear Ygtork �n G' neC'tion with this
permit and that applicant as familaa ".uatle;a 1 �ail'l aktw by th rules and
regulations for pert#fts a ouG��r�ed ,the easun , Sauty Wiffdsbrls Street
Cut Permit Manual
* * PERMIT 'TO BE KEPT ONQ$ A$ ALL TIMES;'
Issued by ---- ---- fir T i t l e
Date Completed
----------------- e d B y sE
APPLICATION FOR STREET EXCAVATION PERMIT
�. TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
TOWN HALL Jar°
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 roa rook, Conn
Location of proposed work 811 Graham Road
Describe fully nature of permit requested strip existing driveway dress with process gravel,
grade, roll and pave
Starting date Approx.time for completion
Call before you dig no. 20041801838 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
jo
Indicate North Prop.size of cut
No.cuts
Amt. of Deposit S by
()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: 6�iiLli Date: 4/28/04
Title: ce Gre_�. D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Job Location:
Description:
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Quote Good for 60 Day .
Special Attention: 1/2 Pay ent Upon Starting, Bala n
�) Contract ��\
Permit
ONE YEAR GUARANTEE ON WOR HIP&-MATERIALS. �z �7,Date
CBUD