HomeMy WebLinkAboutDriveway Street Cut Permits 398 Nevers R 0
Ab TOWN OF SOUTH WINDSOR INSPECTION REPORT
hermit No. 3991
Location 0398 NEVERS ROAD Cont ,aetS ""$(TfTE3D�:r+& SONS
ACYctres$ 121>.i`, IXDA ' RVILLE ROAD
Type Work DRIVEWAY :::, 'a ";< s;
K Ct:-1:::, 16
Date Ins -`3<'- `f'•
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Time Insp Needed
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♦ Permit No. 3991
i Town of South Windsor, CT
Date O5/27/2005 Street Excavation Permit
Expiration Date 05/27/2006 r.,,..'n f•.'
Descrip: t` y r•
A licant
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Name BOUTIN `
& SONS 3 'u 0' 8NEVERS ]F D r
Addr. 121 WINDSORVIL4Fr' f.'` " h' ? '` •f t"�'` E"
BROAD "f ,`:: ""',r <:jxi::":``•y:,•'' .'.:. ;.'..;<:;.r`:a: tt':.�?: .:;t':, +
BROOK CTF
Phone (860)623-2526 «tr s•.'r.: "see °"
Applicant agree's £q;. tirr"
0,151
h Win 'g.d.r—. e .mount of bond
required and to rei 'lir e` tl�- ' T orsira enses
''t'` ;. ,t3Jt; '"'✓ .L�' t y 'Qr
incurred by the Town �«e r iiY� narlc or ' 'epai r .i cn }ecton with this
permit and that app ;.I&nt'`aa' <': " m ,;" '" %' 1"?l'ab lde...'by' .the rules and
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regulations for permits as'pu l iied" ii; tke'Fr�rr .ofxSo"'%th'`.,W i r sor's Street
Cut Permit Manual. ids 3 ryG s t
* * PERMIT T&:-,B&''f LT 6'fi •t% Q�L:' G<E:A. .,. IF
.ICES.
Issued
by ---- l� � Y rT1t2 °"------------
Date Completed ........ — Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR O�a`
PUBLIC- WORKS DEPARTMENT 3
t TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
C
Name of Firm
Boutin & Sons Const. Co . Phone No. 623-2526
Address of Firm 121 Windsorville Road Broa rook, Conn UbUlb
Location of proposed work 3 9 A Nava r c R n n d
Describe fully nature of permit requested Grade xi sting rlrivL-way aryl gravpl if nPL-&,d
grade, roll and pave
Starting date Approx.time for completion
Call before you dig no. 20052101302 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town Of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop. size of cut
No.cuts
Amt.of Deposit$ by
()Cash()Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee 8
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.
Signed:. Date: 5/25/05 .
Secretary
Title: D.L.#
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES
Job Location: 5
;! Description:
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c'" q L c
Quote Good for 0 Days. 1 �� • '
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pres.
CBUD �� Date S
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