HomeMy WebLinkAboutDriveway Street Cut Permits 11 Kent Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3588 Cont..rACt''ts`r'`
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Location 0011 KENT LANE 121'':WIND,$Ok4k:;I,LLE ROAD
Type Work DRIVEWAY
9a
BROAD BROOK CT'».06016
P.,hone N6..(860)623-2.5,26
Date Ins Needed
p ------------ Date R #
Time Insp Needed _---_ Tip Tar -47
Inspected By �����.y� i
Work in Progress777
Inp'�t Date
Permit No. 3588 Town of South Windsor, CT
Date 09/11/2003 Street Excavation Permit
Expiration Date 09/10/2004
Descrip:
Applicant hocat`jon
Name BOUTIN & SONS 0f11 KENT LANE
Addr. 121 WINDSORVILL9 rROAD:::
BROAD BROOK CT 06g16; Tyrge of.;iorY.,x3�2TJE'WAY
Phone (860)623-2526
Applicant agrees'; to fur4sh 'the Tak+za ref Solzth Windsor .t13e' ania�unt of bond
required and to rei nbitrse the Tow ;4 Sough Sr14asor; fox any expenses
incurred by the Town f:ar ma1ht: nance or''fepair"work ' xi co.rin ction with this
permit and that applJ can i s sfaml:. a 4l,
.:abYde ,.by the rules and
regulations for permi't,s as out inecl in Che Tort of SO'd tK?: nds' is Street
Cut Permit Manual.
* * PERMIT TO ON J03 $1TE `XiT ALL;;:TIMES.
itle
Issued by / T
lam_!/ "�_ f�
Date Completed Inspected By � �Q�
APPLICATION FOR STREET EXCAVATION PERMITTOWN OF SOUTH WINDSOR
PUBLIC, W, OR KS DEPARTMENT �S'S
LL
1540 SULLIVANAAVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm
Boutin & Sons Cons Phonet - Co. 623-2526
N
Address of Firm121 In sorvl e oa roa rooko.,
Location of proposed work 1 1 Kent Lane
Describe fully nature of permit requested s triD driveway add grave , r0 an pave
Starting date Approx.time for completion
Call before you dig no. 200336020 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled Out by To Of SO Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop size of cut
No.cuts
Amt.of Deposit S by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee S
S
Applicant is responsible for contacting Amt. Due Town
the Police Dept.and C.S.Y.D. by date
I AGREE TP 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: 9/9/0 3
Date.
Title: Secretary
. D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Job Location: /
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�. �. Description:
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Quote Good for 60 Days. R ,
Special Attention: 1/2 Payment Upon Starting Balance Upon Completion.
i� 'Contract Permit
ONE YEAR GUARANTEE ON WOR M SH P & MATERIALS. `\) L R- GGrcv� F
CBUD L Date
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