HomeMy WebLinkAboutDriveway Street Cut Permits 21 Rockledge TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3665 Contr., o" bb'tr'r1N- &::.:,SONS
Location 0021 ROCKLEDGE DRIVE Ad'areg,s, ',121 IND.S,OR-VY-T ,LE ROAD
Type Work DRIVEWAY S2OA5` bOQ CT``Q..6016
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Permit No. 3665 Town of South Windsor, CT
Date 04/06/2004 Street Excavation Permit
Expiration Date 04/06/2005
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Descrip
A licant >
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F:^ Lo at on
Name BOUTIN & SONS1 ROCKLEDC+R.DR>IVL
Addr. 121 WINDSORVILLS Ft'ChhAD;?% ",:':..:::..<"i`:;a,
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BROAD `.
O D BR
OOK CT �6 Q/'6 1
Phone (860)623-2526
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A li pp cant agrees4 t"n"''ft:x:ri°>0:1�`the T 9¢%}: a til g 1 Winci`So,r';''z1 e' arit0 nt of bond
required and to reimbor'se:.:' :ner;off'.,, >: ., u :
T .�3..:.4 :`ah` Qr fY<s< TS: 5'.�nses
incurred y the T o wrF;: f c aid>' .>:.:. a n' -::d r" .:`: : ' a:` `s;;:
.,.: . ?? p fir .<<2nc. tt1nctiin with this
permit and that a lic �' : .;
PP a' ;Saf ., 1 #13:>: ? "1` cl 8 'e rules and
regulations for permi',s as; nclsor's Street
Cut Permit Manu
al,
* t ` w7PERMIT T �r ... 'M ::: > . .MF:S,l
Issued b
ry
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Date Completed --------------- Inspected By
r',rrt-At—AIWIN PUK STMEET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR 3(r,5
r PUBLIC- W,I,OO�KS DEPARTMENT
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1540 SULLIVANAAVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm
Boutin & Sons Const. Co. 623-2526
Phone No.
Address of Firm 121 Windsorville Road Broad Brook Conn 06016
Location of proposed work 1 R n r k 1 P d¢P
Describe fully nature of permit requested t a ri r7
gra grarlP r�l 1 and nave
Starting date Approx.time for completion
Call before you dig no. 20041500017 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
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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
Amt. Due Town S
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 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: 4/5/04
Date:
Title: C��if /�L /� e
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Jots Location: ff
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Quote Good for 60 Days. - - •• • ' '• '•
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completi n.
Contract sa � Permit
ONE YEAR GUARANTEE ON WORKMANSIJ & MATERIALS. �� �es.
CBUD 1Sco V �� Date