HomeMy WebLinkAboutDriveway Street Cut Permits 80 Palmer Dr TOWN OF SOUTH WINDSOR INSPECTION REPORT
r
Permit No. 3549 Contractor BOUTIN &:.SONS
Location 0080 PALMER DRIVE Addxe: s 121 EVIL7DSORVLLLE ROAD
Type Work DRIVEWAY R4AA BROOK CT "U6016
Phone:No (,8 ?)6 3'r252.6 `<
Date Insp Needed Date ''Tnsp
Q
Time Insp Needed
Inspected By — _, ,i�
Work in Progress
Permit No. 3549 Town of South Windsor, CT
Date 07/21/2003 Street Excavation Permit
Expiration Date 07/20/2004
Descrip:
Applicant Locat:,ipn
Name BOUTIN & SONSCALMER3RIUE
Addr. 121 WINDSORVILLE ROAR
BROAD BROOK CT06016 ape of:; ork DRIVEWAY
Phone (860)623-2526
F.
Pi
Applicant agrees to fur3�5k3' the T6ysfa13th Windsor the..,.,,,amount of bond
s
required and to reimburse the .Tavrn : i�� ottkitrepr far axiy'' xpenses
•,r
incurred by the Town fesr ma nt trance or repair work iu: canatection with this
permit and that applicant is amil1AjC iYEx and w-i11i?e by he rules and
regulations for perm :�s as ouC"1ined :"% t,he.° T of South is nd'sor's Street
Cut Permit Manual.
* * PERMIT TO $E' INEPT ON Jb3B. SITE AT ALL:: TIMES.
Issued by ----� ---- title
Date Completed _------- Inspected By --------
APPLICATION FOR STREET EXCAVATION PERMIT
OWN OF SOUTH WINDSOR
PUBLIC, WORKS DEPARTMENT
TOWN HALL 1-01540 SULLIVAN AVENUE ��
SOUTH WINDSOR, CT 7j
FEE 25.00
Name of Firm Boutin & Sons Cons t . Co. 623-2526
Phone No.
Address of Firm 121 Windsor , . Ile Road Broad Brook, Conn
Location of proposed work 8 0 Palmer Drive
Describe fully nature of permit requested dig Out existing driveway au in gravel , grade
roll and ave
Starting date Approx.time for completion
Call before you dig no. 20032900901 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town Of So wlndsor
two copies of separate drawing Paveme
nt
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.B.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 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: 7/17/0 3
Date:
Title: C.11 D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Description:
i U
5-3
Quote Good for 60 Days.
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
0 Contract
Permit
ONE YEAR GUARANTEE ON WORKMANSHIP&MATERIALS.
rpa
j CBUD Date