HomeMy WebLinkAboutDriveway Street Cut Permits 24 Highview TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3466 Contractor BOUTIN & SONS
Location 0024' tfTGMV. W ROAD ' Address 121 WINDSORVILLE ROAD
Type Work DRIVEWAY ., BROAD BROOK CT 06016
(29 e o. (860 )623-2526
Date Insp Needed s
Time Insp Needed a :to 4M
Inspected By
Work in Progress QK
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C7 A 0 �r
' Date
PewwKt No. 3466 Town of South Windsor, CT
Date 04/17/2003 Street Excavation Permit
Expiration Date 04/16/2004
Descrip:
Applicant ,; , Location
Name BOUTIN & SONS G W ROAD
Addr. 121 WINDSORVILLE R A
BROAD BROOK CT 06 6 RIVEWAY
Phone (860)623-2526
Applicant agrees t f or the amount of bond
required and to reimb h r*-f r any expense
incurred by the Town r""� „pai Iji connection with this
permit and that appli a a , Aria ide by the rules and
regu � ations for permit - uth Windsor ' s Street
Cut Permit Manual .
to
* PERMIT TO le ALL TIMES.
m
Issued by R 1-11711 T e 1 1 ih
Date Completed Inspected By
APPLICATION FOR STREET -31�
APPLICATION
OF SOUTHEXCAVATION PERMIT
PUBLIC WORKS DPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm `E S Phone No.
Address of Firm
Location of proposed work- 2 Hi g view Road
Describe fully nature of permit requested_ Strip Driveway, ;trade, roll and pave
Starting date Approx.time for completion
Call before you dig no. 200 31 5 O 19 9 O Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Tows] of So .°Windsor
two copies of separate drawing Pavement C„ut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit S by
O Cash(1 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 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' ��J�
°�"i Date:
Title:
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Description:
CArl
13177
Quote Good for®Days.
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract
Permit
n/
ONE YEAR GUARANTEE ON WORKMANS IP &MATERIALS. I7 V �� / ���'`` p't LI -I
CBUD
���`'' Date