HomeMy WebLinkAboutDriveway Street Cut Permits 38 Riverside TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3540
Cont;:rat'tor"BOUT'.IN:&,.SONS
Location 0038 RIVERSIDE DRIVE
Type Work DRIVEWAY Address 's 121 .INDSORVILLE ROAD
BROAD 8RO(]IC CT""'Q6016
Fhone NCi ;(B.0).623 25,26
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Date Insp Needed
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Time Insp Needed
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Inspected By f
Work in Progress "
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Input Date -- �
Permit No. 3540 Town of South Windsor CT
Date 07/02/2003
Street Excavation Permit
Expiration Date 07/01/2004
Descrip:
Applicant Lbcatio.n
Name BOUTIN & SONS QfiY38 ,RIVERSSDE DRIVE
Addr. 121 WINDSORVILLE RQAD
BROAD BROOK CTI 060:16 Type of Work <FRIVEWAY
Phone (860)623-2526
Applicant agrees to;Purtish the„Tctias .t�f Sei(ath, Windsor the amAunt of bond
required and to reimburse the Town,,or�.nth IiYadsor ,for ariy'eXpenses
incurred by the TowYl fSr maaiitenance oz repair work 'in connection with this
permit and that applicant is" ami� a W a ` wzll: al�ide:`by G'he rules and
regulations for permits as outlined iri Lhe Sc�tii#n of S:buth. 'T ndsor's Street
Cut Permit Manual.
* * PERMIT TO SE' EpT QN JOB<SITR AT A: :: TIME:S.
Issued by __
Date Completed __ �• = ,fly Inspected B fl iTizi-6, °LG-
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
3s y0
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WIDSOR, CT
FEE 25.00
Name of Firm + S Phone No.
Address of Firm
Location of proposed work_ 3$ Riverside Drive
Describe fully nature of permit requested_ Strip driveway add gravel, grade , To an pave
Starting date Approx.time for completion
Call before you dig no. 2 0 0 3 2 9 Traffic Services Control No.
Shcvr sketch of proposed urork or furnish To be filed out hV Toy.-n of So. i c�
two copies of separate drawing
I £l T
Pavement Cut
' 1
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 $
Amt. Due Town $
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. IL by date
I 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 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:
Date:
Title: �C/2 /� T D.L.# —
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES
Job Location:
► �. Description:
13
Quote Good for 60 Days.
Special Attention: 1/2 Payment I Inon Starting, Balance Upon Completion.
�! Contract Permit
ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS.
CBUD cA3 a "N/� L Date