HomeMy WebLinkAboutDriveway Street Cut Permits 57 Hillside TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No, 3992 Ccnt;re or BOU &a:,SONS
Location ,.% ddre�s3gs 121 ,FT ORFf7LLE ROAD
Type Work DRIVEWAY �nD32QQ, 0:6016
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Permit No. 3992 Town of South Windsor, CT
Date 05/27/2005 W """""zH•• Street Excavation Permit
Expiration Date 05/27/2006 ';
Descrip ;: x..• ::' r,.y ,.. ,
APP licant ^s
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Name BOUTIN & SONS s N7 HI'LLSIT ,`.
Addr. 121 WINDSORVIL E%" BAH
BRO
AD BR
OOK CT;�0
Phone (860)623-2526Ij
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Ap
plicant
cant a re e< ""t''a Y't h PP g � �UIY'�`"`^•, e..: `:f�'�, h Win" h ,
��`�:,,.. ,� �'ap:�;;..t � amount of bond
required and to red &V,'Vs '' € � o t '
€s,or�p milt expenses
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incurred by the Toc4n, r l �enarf "off a r z onziectton with this
permit and that appli+�ant`'?a ......
; '13iSie,;.`by` t'he rules and
regulations for permits a !'' i 'C;lYi'e c3'>sl?y.'t}? ;• ya'of , ti`Fth :::W.inc'sor s Street
Cut Permit Manual.
* PERMIT TIM'ES.
Issued by
Date Completed ___—_------ Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
` TOWN OF SOUTH WINDSOR `
PUBLIC WORKS DEPARTMENT 3
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm
Boutin & Sons Const . Co. Phone No. 623-2526
Address of Firm 121 Windsorville Road Broa Brook, Conn obon
Location of proposed work 47 Hillside Drive
Describe fully nature of permit requested Complete dig out of driveway add process gravel
grade, roll and pave `
Starting date Approx.time for completion
Call before you dig no. 20052103182 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 S by
()Cash()Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee $
Amt. Due Town S
Applicant is responsible for contacting
the Police Dept. and C.S.Y.D. by date
1 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 1 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.
za�
C—) 5/25/05
Signed: Date:
Secretary
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
J OFF STEEP ROAD
' ob Location: ,
Description:
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30 'y
Sq a WI,f
l
'30
Quote Good for 6 Days.
CAW
Special Attention: 1/2 Paymen Up n Starting, Balance Upon Completi l �`
i
Contract Permit
ONE YEAR GUARANTEE ON IWORKMA HIP & MATERIALS. Pr
CBUD faL Date � a