HomeMy WebLinkAboutDriveway Street Cut Permits 40 Steep Roa TOWN OF SOUTH WINDSOR INSPECTION REPORT
Per&ii t No
Location 3652
0040 STEEP ROAD
Type Work DRIVEWAY Con,G.r:aCtor "BOUTiFh;;,&
Address SONS
122 WINDSORVI
BROAD gROOK ' .LLE ROAD
,.,Phone `No (85.07 62�.., CT, 06016
Date 2526:.
Insp Needed
Time Insp Needed _ Dates Insp
Inspected BY -- _ 'T'3t1e I�zSp
Work in Progress
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Input . �—
bate _ 1�j
• Permit No. 3652 Town of South Windsor, CT
Date 03/29/2004 Street Excavation Permit
Expiration Date 03/29/2005
Descrip:
Applicant Isocat]on
Name BOUTIN & SONS 6.040 STEEP ROAD
Addr. 121 WINDSORVILE'.ROAD
BROAD BROOK CT:. 46016pe p '. Wox1L`.;DRIVE3dAY
Phone (860) 623-2526
Applicant agrees to furn :sh the Towia ;af Sbu:th wirlaspi. ;the amount of bond
required and to rezrtbitirse th:e 7cwrL: q Sp; th ls:azdsor iffor any expenses
incurred by the Town. E r maan enai`' e or'`'repair" Wort ..an connection with this
permit and that app7 want is:l: famal`ia w, ;t ! tl wall "abide.,by the rules and
regulations for permits asutline.cl an the Igssn of s'otiath .:k?.an€3sor's Street
Cut Permit Manual
* * PERMIT TO BE I PT "ON 30}3: SI`PE": T 'ALI, TZ MES.
Issued by
--------- ------------- --
Date Completed ________ Inspected
ftrjn iuA,nuN FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC, WORKS DEPARTMENT 5�
TOWN HALL 3
1540 SULLIVAN AVENUE
SOUTH WIDSOR, CT
FEE 25.00
m
Name of Firm
Address of Firm Phone No.
Location of proposed work t'
Describe fully nature of permit requested
v � I
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 T)wr>I of So. �,��u5�tr
two copies of separate drawing
• Pavement Cut
Indicate North
Prop.size of cut
No.cuts
^ Amt.of Deposit S by
/[1 ()Cash()Check#
' Cut size after Perm. Patch
1 No.Cuts
Final Billing S
Amt. Due Payee S
Applicant is responsible for contacting Amt. Due Town S
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 0
SOUTH WJNDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH TH
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN T
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:
Date:
Title:
D.L.# "
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES