HomeMy WebLinkAboutDriveway Street Cut Permits 41 Juniper L TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3953 Cont: .aetd'r ' GI7'Y` F3w& SONS
Location 0041 JUNIPER LANE kddre5„g 121< :,*1IigAS(7fVILLE ROAD
Type Work DRIVEWAY '>s4> -`"
wyf ROAD 4iRWW CT>:>..06016
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Permit No. 3953 Town of South Windsor, CT
l; Date 04/28/2005 Street Excavation Permit
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Expiration Date 04/28/2006 "f
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Applicant
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Name BOUTIN & SONS
Addr. 121 WIND O S RVILL'
BROAD BROOK CT ?06416 { Type E7� i€aYS )3gI.VWAIz:'`
Phone (860)623-2526
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Ap
plicant PP t agrees to`,f'�n .5;}y>the ;G '";,r, Win'sQ l?. .,<�.. • �.;:� c�� ,r.:4;tie?,.amount of bond
required and to reiyeUr�e:::'t.hj%'i o JTYr;'t� % " u h>.>: '">"`r r
':' �xzs'�?. :?SP(4nses
incurred by the Town fdi is nzt': :nance or``r `"" i`r'`t 'rk> with
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P n.2 this
permit and that appl'�.cd'nt :s t'; ^'i' F'1iti3:` ;'- '.><: ,;;; #I"o—b"`:'e
py;,ake rules and
regulations for permits as. crFit .iri`e°d`-Nh '640, •"off" Sgti't' t,ind5or s Street
Cut Permit Manual.
* * PERMIT TO'"$B'`E p,T 0 1:14O$:"'S :T1E;°AI SPcF:I:::.TIM.E'S.
rnG Issued by � / / -.. •..� �"fttl'r.''
Date Completed _--__-------- Inspected By —__—
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- TOWN IDAEPPLRTMENT
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm
Boutin & Sons Const . Co. 623-2526
Phone No.
Address of Firm .21 Windsorville Road Broad rook, Conn 06016
Location of proposed work 41 Juniper Lane
Describe fully nature of permit requested Complete (fig out or c1riveway, aZIZI grave , gra e,
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
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit S by
t)Cash O Check 8
Cut size after Perm. Patch
No.Cuts
Final Baling S
Amt.Due Payee $
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 V9NDSOR 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.
4/26/05
Signed: Date:
Title: Secretary D L#I
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
OFF CLEARVIEW,NORTON
Job Location:
Description:
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Quote Good for 60 Days. ( �`
Special Attention: 1/2 Payment Upon Starting, BalAnce Upon Completion.
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Contract Permit
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ONE YEAR GUARANTEE ON WORKM SHIP &MATERIALS. c�
CBUD n Date 't'