HomeMy WebLinkAboutDriveway Street Cut Permits 21 Greenfiel TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3969 Cont aad'orF BOt T1Pdw.; ., SONS
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Location 0021 GREENFIELD DRIVEdr'dre " 12 ».:7I3pSORV,ILLE ROAD
Type Work DRIVEWAY F• : "'
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Permit No. 3969 Town of South Windsor, CT
Date 05/09/2005 Street Excavation Permit
Expiration Date 05 09 ,f:• _�./ /2006
Descrip:
Applicant ;y ,yr>''" y t.:(• ,...�
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j.WNI
Name BOUTIN & SONS
+ �z�r:. •�' �k. StTFIE'�,22 �RT�, E
Addr. 121 WINDSORVILLE ROAD' F.: .? >ts
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BROAD BROOK CT: 0.b 016 •.,.. °:::'"'" Wr. "' +
',"Of WX� DFtT'i7EWAY
Phone (860)623-2526 f rjFyo a ` `
Applicant agrees q ,fd�.X�sl3,wth$ th Wi�rid : h .::am bunt of bond
required and to reimburse:==j�fa 'Town o :: �rrdsors .+:: y epQnses
incurred by the Tawpoyfe, n f
Gohndit 'on with this
permit and that ap" licarnL by`t, e rules and
regulations for per;)n ;�p§ ::.' uz1: 4k- a �:: xz z: z: .
gt S�rutkx Wiiisor s Street
Cut Permit Manual. ��0
PERMIT`-TO +BE. XQP1r="'ON..
Issued by
Date Completed �— y �'"f '�'4'' a �"��� �°�•T
----------- I?, Pd By ---------
• • vas vii�LL,t r_,n�r�v&IIWA PERMIT
�- TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623-2526
Address of Firm 121 Windsorville Road Broad-Brook, Ct
Location of proposed work 21 G r e e n f i e l d Drive
Describe fully nature of permit requested_ Complete dig OUt o riveway, a process ,
grade, roll and Dave grave
Starting date Approx.time for completion
Call before you dig no. 2 00 519 O Traffic Services Control No.
Show sketch of proposed work or furnish rDeposit
ut by Town of So Windsor
two copies of separate drawing
Indicate North �
t
t 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 S
the Police Dept.and C.B.Y.D.
L„il - - date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SOUTH WJVDSOR 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
Description:
A �
cam•, � � .
ova
30
Quote Good for Days.
Special Attention: 1/2 payment Upon Starting,ng' Balance Upon Com 1
p etion. � - • ' ' '• -•
GUARANTEE Permit
ONE YEAR ON SPATECBUD RIALS.
Date Pres.