HomeMy WebLinkAboutDriveway Street Cut Permits 47 Hillside * TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3700 ContraCtor:Bp:UT-1.1,�,rt5 SONS
Location 0042 HILLSIDE DRIVE Ad€ar'ess Jd:,>;121 :RIN1) ' V.ILLE ROAD
Type Work DRIVEWAY .s "H12OA73 &BOOK CT'::A6016
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Permit No. 3700 Town of South Windsor, CT
Date 05/10/2004 Street Excavation Permit
Expiration Date 05/10/2005
Descrip:
Applicant " Loca ion
Name BOUTIN & SONS HILLS.: DE VRIVF�
Addr. 121 WINDSORVILLE;'''RO'D '.
BROAD BROOK CT 0:6016 '. I`:"`.e;.of• Wor,..„€iRi•U WAY
Phone (860)623-2526 Farr
Applicant agreed t'c5 ftt the TaWk ti "` h WiYlr: e amount of bond
required and to rejmburse;:,t'1i.e: town'"of "Sdsor ` p my ,expenses
incurred by the ToWn for:!:: work in c3naieet:iazi with this
permit and that a p ppicaht � EmY7xxaibh3d �N� abade b t: rules and
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regulations for perrmit8 a9 'tk,flsaned in the To CUMS, 'r's Street
Cut Permit Manual
a * PERMIT•',
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC• WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
.FEE $25.00
Name of Firm Boutin & Sons Const. Co. ' 623-2526
Phone No.
Address of Firm Wlri sorvi e oa roa TOOK Conn
Location of proposed work 42 Hillside Drive
Describe fully nature of permit requested strip existing Zlrtveway add gravel, grade
roll and pave
Starting date Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish TO be(Filled out by Town of SO Windsor
two copies of separate drawing Pavement Cut
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Indicate North Prop.size of cut
No.cuts
Amt. of Deposit$ by
() Cash() 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.
�, 5/6/04
Signed: Date,
Title: SSG G ��-` D.L.#
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PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Description: ( a_
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Quote Good for 60 Days.
Special Attention: 1/2 Payment Upo Starting, Balance Upon Completion.
Contract Permit _
v ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS. ��J
CBUD �TU `/ Date
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