HomeMy WebLinkAboutDriveway Street Cut Permits 140 Northvie TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3957 Coat',&ctor BOUTI :,&,,;.:SONS
Location 0140 NORTHVIEW DRIVE "'1ddr 'x 12• '.rW T:DSOIt`VILLE ROAD
Type Work DRIVEWAY
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Windsor, C
Town of South T
Street Excavation Permit
3957
permit No
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Date f•^
03/2006 F w
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BROAD BROOK � ':
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Date Completed — _-- ------
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT 3 cis l
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Boutin & Sons Const . Co . 623-2526
Name of Firm Pkhone(A&
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Address of Firm
Location of proposed work 140 :Nort view Drive
Describe fully nature of permit requested Strip existing driveway, put in process gravel,
grade, roll and pave
Starting date Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit S by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee 8
Amt. Due Town.$
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: ` 5Z-n� Date:
Title: S D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
OFF ELLINGTON RO
Job Location:
Description:
LrG�2�c-
S
30 _
Quote Good for K Days.
Special Attention: 1/2 Payment URon Sta Ing, Balance Upon Completion. jo
Contract Permit
'ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pres.
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CBUD �U 1�—,-- Date �..