HomeMy WebLinkAboutDriveway Street Cut Permits 18 Sally Dri s TOWN OF SOUTH WINDSOR INSPECTION REPORT 6 7
Permit No. 3181
Location Contractor BOUTIN & SONS
Type Work DRIVEWAY Y
T : . Address 121 WINDSORVILLE ROAD
BROAD BROOK CT 06016
Hone No. (860)623-2526
Date Insp Needed
Time Insp Needed
T`i'rrrne. Z n s p
Inspected By
Work in Progress � .
input' Date l� o� 7 O
Permit No. 3181
l Town of South Windsor, CT
Date :pfy/22/2001 Street Excavation Permit
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Expiration Date 08/22/2002
Descrip:
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Applicant
Location
Name BOUTIN & SONSi8' SALLY DRIVE
Addr. 121 WINDSORVILLE ROAQ v,
BROAD BROOK CT 06016 Eype, of Work,,, DRIVEWAY
Phone (860)623-2526
App1.icant agrees t4 f rn h'.the,"To af, S ut{i Windsor the amount of bond
required and to reimburse he T6wn w 00th"` Ind or 'for any expenses
incurred by the Town far maw, Mena cue �r�;�epair � rk,'in. connection with this
permit and that applipant :° s ,' amiliar w ih and wi11 abide by the rules and
, .
regulations for permi t `�aSl I'll," ~i r� the: ..Town" of .South Windsor's Street
Cut Permit Manual . >
* * PERMIT TO BE `KEPT 'ON 408 SITE AT ALL TIMES.
Issued byi" -- E Title
Date Completed � � Irt8pected By���
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
t PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Const. co. Phone No. 623-2526
Address of Firm 121 Windsorville Road Broa Broo , Conn 06016
Location of proposed work 18 Sally Drive
Describe fully nature of permit requested Complete dig out of existing driveway putting in
6" of process grave , gra e, roli and pave
Starting date Approx.time for completion
Call before you dig no. 20013303138 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
Indicate North Prop.size of cut
No.cuts
Amt. of Deposit S by
() Cash () Check#
Cut size after Perm. Patch
No. Cuts
Final Billing S
Amt. Due Payee S
Amt. Due Town $
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 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.
/ 8/17/01
Signed: Date:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
r Job Location:,, Don' t leave estimate °
Description:
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Quote Good for 60 Days. ,
Special Attention: 1/2 Payment Upqr4Startin , Balance Upon Completio .
Contract Permit
ONE YEAR GUARANTEE ON WORKMAN IP & MATERIALS. / Pres.
CBUD �LJ f> ��.3U�3/�'� Date at