HomeMy WebLinkAboutDriveway Street Cut Permits 33 Riverside TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 3688 Contr,4,o't6't"''$tSYjT3d::: SONS
Location G ;uVlMsM."'MIVE AS.dress•< %"`121 kd NpSORV<Zi LE ROAD
Type Work Df iV AY h. B-ROAD BRflQ. CT"0..6016
P lone.:: o` 62.r3'_2'5.26
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Permit No. 3688 Town of South Windsor, CT
Date 04/27/2004 Street Excavation Permit
Expiration Date 04/27/2005
Descrip:
Applicant oc L. ion
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Name BOUTIN & SONS R�VBRSIDE �1RIV&
Addr. 121 WINDSORVILLEyROAL3
s:
BROAD BROOK CT d:6,016 Work JR'iU WAY
Phone (860)623-2526
Applicant agrees t'rs fax% c4he ::T-6%x}£ ai th Windsythe sntoznt of bond
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required and to rezmiuxse t o Town of Sb%t (A s lsor t>r any expeizses
incurred by the Town far maxnenancY Y fWork i')ipn�ieeti sn with this
permit and that app': ica'zit:'".'.t' "<: :�m .:fif:., 'g j ' . : ,de:z0.0
b "'' h rules and
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regulations for 'g permits �Q2 in the ,dawn of C i' Wzim sa'r's Street
Manual.Cut Permit
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* * PERM IT0 BE KEPTdLT T. A TI13t x
Issued by e " V
Date Completed
».... 'TAi'spec�;ed""By
Lal 1 Ll`-niIUty rvt'C 0tKrl:•-I EXC:AVATION PERMIT
TOWN OF SOUTH WINDSOR
► PUBLIC WT,ORKS DEPARTMENT (�
LL
1540 SULOLIVANAAVENUE ��
SOUTH WIDSOR, CT
FEE 25.00
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Name of Firm Boutin & Sons Const . co. 623-2526
Address of Firm 121 Windsorville Road Broad BrP ok,hone V�Conn
Location of proposed work 33 Riverside Drive
Describe fully nature of permit requested dig out r lvewa y, put in grave , g r a
and ave
Starting date Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish rofDeposit
ulb y Town of So Windsor
two copies of separate drawing Pavement
Indicate North
t
t S by
()Cash()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 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: ' _ Q
Date: � 2. 2 _ /
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
OFF NEVERS RD
s - Job Location:
Description:
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Quote Good for 60 Days.
Special Attention: 1/2 Payment Upo Starting, Balance Upon Completion.
Contract Permit -/ 7 Z r I
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pr(
,CBUD -
w ! �� Date