HomeMy WebLinkAboutDriveway Street Cut Permits 35 Rustic La t TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3627
Location 0035 RUSPIC LANE Contr.acCcir BOUTTN,.; SONS
Address: 121 WIN.D,S0PV.ILLE ROAD
Type Work DRIVEWAY
$R CT'<:06016
Phone 'b7c {80)623 2526
Date Insp Needed
-------------- Datei?Sj�
Time Insp Needed
Inspected By
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Work in Progress —YS ILL
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Input Date
Permit No. 3627 Town of South Windsor, CT
Date 11/10/2003 Street Excavation Permit
Expiration Date 11/09/2004
Descrip:
Applicant Locatyan
Name BOUTIN & SONS 4C�3$,RUSTIC �1SNE.
Addr. 121 WINDSORVILL' RS�31I?''
BROAD BROOK CT `OF016 Tae of ::ta�<ir pgI'VEWA
Phone (860)623-2526
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Applicant agrees to fuxnasFt the TQWzzf youth Windsor the .amount of bond
required and to reimbUrse 'the how of!;BouhJzndor for, any 'expenses
incurred by the To.,:
fOr. R1ai-'At%nance or repair worts yn"tonn ct with this
permit and that apply oa'nt 3 ssylyar ' ryt1� xsd,w�11 abide by tie rules and
regulations for permys as dUGX.ined xri the TOSyy� p,f $du, h Wixidsor s Street
Cut Permit Manual.
* * PERMIT TO BE`X8P.'4 ON 'SOB SINE AT ALL TIMItS.
Issued by
___---- ----—_L T i t l e
Date Completed -------- Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
J
TOWN OF SOUTH WINDSOR
PUBLIC, WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm Boutin & Sons Cons t . Co . 623-2526
Phone No.
Address of Firm 121 Windsorville- Road Broad rook, Conn
Location of proposed work 35 Rustic Lane
Describe fully nature of permit requested Strip existing driveway a gravel , gra ,
and pave
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 bV Town Of So 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
No.Cuts
Final Billing S
Amt.Due Payee $
S
Applicant is responsible for contacting Amt.Due Town
the Police Dept.and C.S.Y.D. by data
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.
11/3/03
Signed: Date:
Secretary
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Quote Good for 60 Days.
�- Special Attention: 1/2 Paym nt Up Starting, Balance Upon Completion.
( i Contract
Permit
ONE YEAR GUARANTEE OIR MATERI LS.
I
CBUD
Date
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