HomeMy WebLinkAboutDriveway Street Cut Permits 21 Hollis Ro TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. . 3273 Contractor BOUTIN & SONS
Location Type Work Address 121 WINDSORVILLE ROAD
DRIVEWAY `
BROAD BROOK CT 06016
No. (860)623-2526
Date Insp Needed '
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Permit No. 3273 Town of South Windsor, CT
Date J 04/22/2002 Street Excavation Permit
Expiration Date _04/.22/_20Q$
Descrip:
Applicant ° � Location
Name BOUTIN & SONS L ROAD
Addr., 121 WINDSORVILLE R
BROAD BROOK CT 060�6 � DRIVEWAY
Phone (860)623-2526
Applicant agrees he tind or the amount of bond
required and to reim o ` th r r any expenses
incurred by the Town ena pai i connection with this
permit and that appli ' vit an ide by the rules and
regulations, for' permit 1 f uth Windsor 's Street
Cut Permit Manual . `` g
p�'"� � • s&€€°"pit F$1 k�
* * PERMIT T � K LL TIMES.
Issued by
Date Completed Inspected By
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 Cons t. co. Phone No. 623-2526
Address of Firm 121 Windsorville Road Broa Brook, Conn
Location of proposed work 21 Ho l_1 i S goad .
Describe fully nature of permit requested Complete dig out of driveway, putting in - "
of gravel, grade roll and pave
Starting date Approx.time for completion
Call before you dig no. 20021600981 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
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 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: Date: 4/16/02
Title: -G D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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Description: 6�12
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Quote Good for 60 Days. _
Special Attention: 1/2 Payment U on Starting, Balan a Upon Completion.
\1 Contract Permit
ONE YEAR GUARANTEE ON ORKMANSHIP &M ERIALS. Pres.
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CBUD Date
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