HomeMy WebLinkAboutDriveway Street Cut Permits 20 Horizon C a
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4051 Cont;r:a 'br"' 'OU"tTN•:;;: SONS
Location 0020 HORIZON CIRCLE
ArTdreqs <' 127, :. IN,DS0 tVILLE ROAD
Type Work DRIVEWAY iiBROAD`:SRQ0K ,C'P::;.06016
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Permit No. 4051 Town of South Windsor, CT
Date 07/28/2005 Street Excavation Permit
Expiration Date 07/28/2006
Descrip:
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ApplicanPCA*r ion
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Name BOUTIN & SONS #TQO HORIZOI* CTRLE "'
Addr. 121 WINDSORVILTa'E;:+F.OAII"' :
. .
BROAD BROO
K CT'0 ,�0.1
5 6.,,;
Phone 860 -623 2 526
Ap
plicant PP ant agrees'to £..0 ri' s" ca
k} the �.::: ,�m�"��'d; �h Wi .`the amiiunt of bond
required and "`'''`"`
q to rea m nrs:.e< h T tam .' b � 3v'.:.'>`i or `b' .:ia.'
{.. � 44. r'I x.. ny:,.,exp`enses
incurre
d b the
xl �Ax';:fiaY ;enaYae:;;tir',���t.air::;.;#4��rk; gf�:<;::�vnneot�'on .with this
permit and that applip. : ' ' Ia :d'e b :fie rules and y. Y''t
,... ` .
, d or s Streetregulations for permits S L:,:h `Win
Cut Permit Manual.
* * PERMIT TQ:;.$'E;+s�k PT '„t3DT.:i7.Q' >SI.T :>a:1YT ALL S*.� <rzM�
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Issued by
Date Completed --_---__ Inspetcted By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR I
PUBLIC- WORKS DEPARTMENT ,��
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623-2526
Address of Firm 121 Windsorville-Road Broacrook, Conn 06016
Location of proposed work_ 20 Fln r; 7 6 D C i r C 1 a
Describe fully nature of permit requested -q t r i p e X l s t;n s d i vewa3,, dress with p r e e e s s
9rayPl � grayly rnll and P@y
Starting date Approx.time for completion
Call before you dig no. 20092901922 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt. of Deposit$�by
O Cash O 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. b
y 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.
Signed: Date: ( ��
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Job Location:
Description:
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3a
Quote Good for Days. . .
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pres.
CBUD -? ) Date
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