HomeMy WebLinkAboutDriveway Street Cut Permits 84 Jessica D TOWN OF SOUTH WINDSOR INSPECTION REPORT
f
Permit No. 3962
Location 0084 JESSICA DRIVE C°A't'7actor BOUTI*S""l:&.,,t40NS
Type Work DRIVEWAY Y3 12sarW7DSOR"FY LLE ROAD
zx... 3
K`CT'":>06016
.;.s
Date
sP Needed
Nee
xz
Time Insp Needed a •'"x:x.•".
------- T iAfe
Inspected B
y s:
r..
W ..a.;
r k i n x.
P r 0
9
r e s s
T-2,wt -i""' Y_T4'C/
ate
^Y.:x
ss
:
:
:
�� fx
f--
1,
Permit No. 3962 Town of South Windsor, CT
Date 05/04/2005 Street Excavatio
n Permit
Expiration Date 05/04/2006
Descrip: �;.:•:.:.+ 'f F a...
Applicant
`
3
• ,r Sr
Name BOUTIN & SONS ET TESSICA:°:aDR•h~
Addr. 121 WIN :>•:x.::a�`:.:;::.e:.:D S O R V I LI'E F�Iti'OALT .a:.
4
BRO
AD BR
OOK CT)
44£^'Q.1
Phone (860)623-2526
` sthApplicant agreed ta;.5U.x ....
i ` nun of bond
required and to r
q '�`:n:T'z:>'<".z�<:"'.:�'
...,
incurred b the Towh : `''y pr 'ntt: t1't'*6nance or repJAair`<wo.r:k':3 �z'e.ti ri>
� «�' n e.ction with this
permit and that appl cant abi!e:>by g'he rules and
regulations for permits as atxt inedz3 � i TQ of Stth' indsor's Street
Cut Permit Manual.
F
* * PERMIT TO"`<J E' I E1?T, ON rT$B iVrE' AT,
;,
C ? •,
Issued b
<..
,; p Y
Date Completed Inspected B
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC, WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
ffi
Name of Firm Boutin & Sons Const . Co. k �eeo 623-2526
Address of Firm121 In sorvl e oa roa o ,
Location of proposed work TT—Jessica -Drive
Describe fully nature of permit requested_ Strip existing driveway, ress w!th process
gravel , grade, roll and pave
Starting date Approx.time for completion
Call before you dig no. 20091 803261 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 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.
112
Signed:
g Date:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Description:
fi
33
500 �u I'3 `
j
1 �j
Quote Good for 60 Days.
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract Permit
ONE YEAR GUARANTEE ON WORKMANSHIP &,MATERIALS. Pres
CBUD C) 1 �jn�_ Date