HomeMy WebLinkAboutDriveway Street Cut Permits 585 Rye Stre • , TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3491 Co9.t;r6Ctor BOZ7Tfi'N:,& SONS
Location 0585 RYE STREET 1.ddress 12J::;WINDSORVILLE ROAD
Type Work DRIVEWAY ::.BROAD BROOK CT:,06016
Phone No (;$60)6'23 252�.
Date Insp Needed
Time Insp Needed _----- — _ T�t[e Insp 1,
Inspected By 9 �`�r `
Work in Progress
Input /� Date
Permit No. 3491 Town of South Windsor, CT
Date 05/09/2003
`" Street Excavation Permit
Expiration Date 05/08/2004
Descrip:
Applicant : I,ocat .on
Name BOUTIN & SONS 05B5.RYE STREET
Addr. 121 WINDSORVILLE;ROAD
BROAD BROOK CE :0b>Q16 Type of Work' DRIVEWAY
Phone (860)623-2526
Applicant agrees to furai Sh th. T4W. of South Windsor :the::::::amount of bond
required and to reimburse the Tom of 86uN C3mdsor; for any expenses
incurred by the ToWn. 'for maintenance cr regai,r wozk in zl
Con.ection with this
permit and that applicant is f mialaX- X th will' abide by
.'the rules and
regulations for permits as ''outlined he Town of South"Windsor s Street
Cut Permit Manual.
* * PERMIT TO JPE KEPT ON C1OB SITE j3T.AI , TIMES.
Issued by —__ j _ Title
Date Completed _-------- Inspected Bye
APPLICATIOONVFOR STREET EXCAVATION PERMIT
N OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT 3 � 1
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm `F S Phone No.
Address of Firm
Location of proposed work_ 5 8 5 Rve Street
Describe fully nature of permit requested Strl D exiStiTlg rlveway lg OU awri a gray
rade roll an pave
Starting date Approx.time for completion
Call before you dig no. 20031900564 Traffic Services Control No.
Show sketch of proposed work or furnish TO bC filled out by Town of.SO wlq(�SOI'
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit S by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing$
Amt. Due Payee S
Amt. Due Town $ -
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. 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: S
Date:
Title:
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Job Location:
Description: ,
QV(A`�- G y
Quote Good for Days.
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract Permit
ONE YEAR GUARANTEE O RK ACBUD
N HIP & MATERIALS. j� ,,�',�4
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Date