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HomeMy WebLinkAboutDriveway Street Cut Permits 889 Pleasant r � TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No, 3814 Location 0889 PLEASANT VALLEY Cont:rac't'or""B'OUT:T:N,..,.& Type Work Address SONS DRIVEWAY 121 WINDSCtR.VILLE ROAD BROAD 'BIIQOK CT:, 06016 gnl Ph ko (86Q)623' 2526.;. Date Insp Needed ------ — Date Time Ins :^1 p Needed "3-- TlMe Inspected By Work in Progress ._- �` --- = � Date ate Permit No. 3814 Town of South Windsor, CT Date 08/04/2004 Street Excavation Permit Expiration Date 08/04/2005 Descrip: Applicant Location Name BOUTIN & SONS 088 .- P4ih9..mgT VALLEY Addr. 121 WINDSORVILlit ROAD' BROAD BROOK CT:'Q6016 Iyrpe of W©rk pRITEWAY Phone (860)623-2526 :' Applicant agrees to funssh.'the Taw1a of South Wiradscir the amount of bond required and to reimburSe';Ehe>Town of::sdut:I 1ndsor for.: any. expenses incurred by the Town for mairtte ax7oe nY e aar'.work 4 'conne,ction with this permit and that applicant':; 5, 'familia"r with'and wi1J akacte by the rules and regulations for permits a's out1"fined art the `T�zwn D Sour:h Win'dsor's Street Cut Permit Manual. * * PERMIT TO $E KR'PT ON gT{5B..S14 AT ALL TIMES. Issued by — Date Completed I,nsected By >lti APPLICATION*FOR STREET EXCAVATION PERMIT �� TOWN OF SOUTH WINDSOR PUBLIC- WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Boutin & Sons Const. Co. 623-252i Name of Firm Phone No. Address of Firm 121 Win Gnrvi 11 P Road Broad Rrnok Cnnn 06016 Location of proposed work• 889 Pleasant Valley road Describe fully nature of permit requested Strip existing driveway a process gravel, grade, roll and pave Starting date Approx.time for completion____ Call before you dig no. 20043100397 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 O Cash O Check# Cut size after Perm. Patch No. Cuts Final Billing S Amt. Due Payee S Amt. Due Town $ 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 WINDSOR 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. 8/2/04 Signed: Date: Title: !1 ✓ D.L.# PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES — Job Location: ' Description: L �0 ` iybV�� 1 05 , f3► T t j a", Quote Good for 6�Days. ti Special Attention: 1/2 Payment Upon Starting I'ance Upon Compiled Contract Permit I ONE YEAR GUARANTEE ON WORKMANSHIP& MATERIALS. J CRUDOV 1 Q h, _ Date - r �r