HomeMy WebLinkAboutDriveway Street Cut Permits 169 Palmer D � � s
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3454 Contractor BOUTIN & SONS
Location 0 `9 PALMER DR1VE Address 121 WINDSORVILLE ROAD
Type Work DRIVEWAY BROAD BROOK CT 06016
0. (860)623-2526
Date Insp Needed s = '
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Time I nsp Needed
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Permij� No; 3454 Town of South Windsor, CT
Date 04/07/2003 Street Excavation Permit
Expiration Date 04/06/2004
Descrip:
Applicant Location
Name BOUTIN & SONS sL DRIVE
Addr. 121 WINDSORVILLE R
BROAD BROOK CT 060 6 RIVEWAY
Phone (860)623-2526
Applicant agrees ind or the amount of bond
required and to reimb h rr r any expenses
incurred by the Town ai I connection with this
Ile
permit and that appli a a ide by the rules and
regulations for permi 'n f th Windsor 's Street
Cut Permit Manual .
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* * PERMIT TO LL TIMES.
Issued by
e
Date Completed Inspected
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APPLICATION FOR STREET EXCAVATION PERMIT
' SOUTH WINDSOR
TOWN O
PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm Boutin & Sons Const . Co . Phone No. 623-2526
Address of Firm 121 Windsorville Road Broa Brook, Conn
Location of proposed work Strip Driveway, Grade, roii anci pave
Describe fully nature of permit requested 169 Palmer Drive
Starting date Approx.time for completion
Call before you dig no. 2 0 0 314 014 7 2 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of,% `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
1
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
1 AGREE TQ 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.
54
Signed: z Date: 4/3/0 3
Title: Secretary D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
'Description:
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Quote Good for Days. • ' - ' '
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Special Attention: 1/2 Payment Upon)tarting, Balance Upon Olomple on.
Contract Permit
ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS. GL<W� are
Date
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