HomeMy WebLinkAboutDriveway Street Cut Permits 29 Rockledge TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3663 Cont eC'0:.r BOUT`IV:-:&v:<,;SONS
Location 0029 ROCKLEDGE DRIVE ad" resa% &21 k'NAS.ORV ,1,,LE ROAD
Type Work DRIVEWAY �7
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Permit No. 3663 Town of South Windsor, CT
Date 04/05/2004 Street Excavation Permit
Expiration Date 04/05/2005
Descrip:
Applicant Location
Name BOUTIN & SONS # 'u RCKL.EDG$ bRIVE "..
Addr. 121 WINDS ORVI LLE..,"RU€!D` i .
BROAD BROOK CT C?6016 WorJ .; RI ' 3�AY
Ph
one z 86 062 -252
3 6
Applicant agrees tb furY77i the 1L3WY C ' tt1h Winds .x tkeaz[otznt of bond
required and to rexanburs ;tkre own'"of`Sbuh &$ isorc'r. n expenses
incurred by the Tow frr tina rio 'ap. t a :vprk i 'c ri eC os with this
permit and that appica3lt ' %�mi rri,tkaz131atie by "t rules and
.. ..A' .. >!i;i••;. ..., ... ., fiat:..r'
regulations for pernG t"5;. 5 et;;t .ned i• tkle QWn .o,£;;;::'r "bC `2'�';tli` dsar's Street
Cut Permit Manual.
* * PERM IT:.aalOs3E;.R$P`. 3SZ` T:° :'A >:;.
Issued
s ued b
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Y
Date Completed T'npec. `"B
Ivly rUK J1KEET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
• PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE 25.00
m
Name of Firm �l Phone No.
Address of Firm
Location of proposed work n
Describe fully nature of permit requested
Starting date Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town Of S(f 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
1 No.Cuts
Final Billing S
C �
Amt. Due Payee $
S
Applicant is res)hnsible 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 Date•_ 4,�
Title:
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES