HomeMy WebLinkAboutDriveway Street Cut Permits 1030 Strong n /rl /a \ _
TOWN OF SOUTH WINDSOR INSPECTION REPORT �.J
Peamit No. 4099 Con:tx'actor.;,$,OUONS
Location 1030 STRONG ROAD ddre$sI k7TTDSf)RCJTLLE ROAD
Type Work DRIVEWAY $&DAIS, BRflQK...,CT"Q6016
Date Insp Needed e Ire . d
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Permit No. 4099 Town of South Windsor, CT
Date 10/06/2005 Street Excavation Permit
Expiration Date 10/06/2006
Descrip:
Applicant C$t3 QS1
Name BOUTIN & SONS 10 b STRONG AQ. AA. Y 4 V
Addr. 121 WINDSORVILLF AQAD
BROAD BROOK CT :O60.16 .; Type"of t sr3 RTV8.-W
Phone (860) 623-2526
Applicant agrees; to"";fraxhl 'the T..razari csfi Sotrt Windsor the„amount of bond
required and to reimb Yse,:.th jow .A;South #4�st} sor ft r any expenses
incurred by the Town f-Or rkkalgtanancs or repair Sao k inr cp}inection with this
permit and that appliud'ht ';s" ;f1a` X1zax€ s>::901 >:`*TlI' ':bides b tl e rules
;. >::...>;:;;:..... ; and
regulations for permits as;. &UtAiriez3 i.'>the>, idsFa:"of Sout3i Kindsor's Street
Cut Permit Manual.
* * PERMIT
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Issued fit/
Date Completed ___— --_-- — Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR y Q`
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 a rook, Conn ann
Location of proposed work_ 1030 Strong Road
Describe fully nature of permit requested Comp ete dig out ot driveway, put In gravel,
grade, roll and pave
Starting date Approx.time for completion
Call before you dig no. 20054100850 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 $
Amt. Due Payee $
Amt. Due Town S
Applicant is-responsible for contacting y
y
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.
g �
Si ned• Date:— 10/4/05
Title:
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Job Location: (--5U,)//J a X� +25.00 permit fee ` 9
Description: aT
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7-0
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Quote Good for 60 Days.
Special Attention: 1/2 Payment Upon Startin Ba ance Upon Completion. 2a CW/oj
Contract Permit
ONE YEAR GUARANTEE 01 W K�ANSHIP & MATERIALS. Pres.
CRUD Date (�