HomeMy WebLinkAboutDriveway Street Cut Permits 182 Oak Stre I
Permit No.
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Type Work
Location 400-901 82 OAK STREET C4xkactor :„.
DRIVEWAY BONS
OUTIN''` ::,
SORtYSLLE RO
CT"''0.6 01AD
To (•g6 )623 2526` 6
Date
In r
sP Needed --_
r
Tile In
T'
e
s Needed
Ins ected B
P
Y
.^ •.--a :
Wor
s; :. o
k
in
9re s s
�•M
zs�
__------------- F t
!
:
te
Permit No.
Date 4005
06/06/2005
Descr peon D Town
ate 06/06/2006 Streeof South Windsor
$. t Excava ti CT
on Permit
Applicant
P icant r,fit€•;K ''�,
k
N
e
B
V
IN �•.�^
d N ..
d :
BROAD d+ AFS''.
BROOK p OK K S
Phone C
n T:'
e 0: E..
6. T.
6
)6
2 3-
2 5
2
6
e
0 f'.
A
9J
z...
P 1 Y�
P i c a Yr.
n t
a �.
r
required u'
S e e`
q i
r e
d
an
d
o.
:tt>..
i
d
t 0
r
e >
xx>.'
t h
n i':
m"u b`� �"
r '�:.
in
curred d
u�
s<.
he
Permit owu ;<.: f..,. ? n
i t andb'r s '.r:`°:. .«•>:<'- S'ktli: . ?o'Y:"?'the^;:a-
inthat a is>.. s�t�tL?an^ceF �F, s?r amount of
PP ic'ant o ^<,r:. ,; cx' ""a"'" bon
regulation, ;:.5>: :.g,.?.«;<:r:Y< :« epair:' hys>. at d
C for eatni.h.; "•'<a;>;:::: a>5,„;<. .Wo. Penses
cut Permit P rmi s as. a:" :...::: >>:;.>,:,::«:; .i. '
Manual. `utinet wxrli'c�n. ct on with this> of ae by Ghe rulesis
:z:: .. trth. and
* rici"so ,
r
s
PERMIT Street
t
#.E''.
TEE P.
sued by01.1
S.
Date
Y,�z nFE ry
e ComPleteda
---�� Inspected _ �---
By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm
Boutin & Sons Const . Co . 623-2526
Phone No.
Address of Firm 121 Windsorville Road -Broad rook, Conn
Location of proposed work 182 Oak S t r e e t
Describe fully nature of permit requested btrip existing rlveWa 7 , dresS Wlt process gravel ,
grade, roll andp ave
Starting date Approx.time for completion
Call before you dig no. 20052203559 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town or so Windsor
two copies of separate drawing Pavement Cut
1
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 $
Amt. Due Town S
Applicant is responsible for contacting
the Police Dept. and C.S.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 1 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 JOBSITE AT ALL TIMES
Job Location: �j 1/e/ra / - `1 d o a �.�.✓ !� ,�/.
' Vescription: OFF
tld/`1
5T� � y
00 6,
l
7-01
3� ST?YO
IV
Quote Good for Days. 1 /36'�, • . . . • -. -.
Special Attention: 1/2 Pa ment Upc Starting, Balance pon Completion.
r J ��� //
Contract CD Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pres
CB LID ��\� � o Date