HomeMy WebLinkAboutDriveway Street Cut Permits 255 Sullivan TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3676 con;t:ractor BOUTTN &„SONS
Location 0255 SULLIVAN AVENUE Address 121WINDS6kV;ILLE ROAD
Type Work DRIVEWAY BF2QAD BRO'6K,CT`,.06016
Phone) No (8f0)623; 2526'<:
Date Insp Needed
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Time Insp Needed
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Inspected By '� 173
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Work in Progress 4611L, 11 T j
Input Date
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Permit No. 3676 Town of South Windsor, CT
Date 04/19/2004 Street Excavation Permit
Expiration Date 04/19/2005
Descrip:
Applicant >,.Locatdn
Name BOUTIN & SONS t255 SULLIVAN.;AVENUE
Addr. 121 WINDSORVILLE.RO.Ap
BROAD BROOK CT 06016;> T''+pe of::'Work DRTVEWASY
Phone (860) 623-2526 J
Applicant agrees to furnish; the Town of,.Soubh Winds:ox the,. amount of bond
required and to reimburse the rl,doh o South W�Ykd'Sor fair any':sexpenses
incurred by the Town for 'rftxnt;enance"''or repair Work::. coma ;ctkon with this
permit and that applicant is m liar vz.i.::h x]d tiien abide by t;he rules and
regulations for permits as out.linec3 zxi the.',Town of South Wi;nj or's Street
Cut Permit Manual.
* * PERMIT TO $E T PT 6N°'y7OB.'S,ZTE AT,,.ALl,, TIMES.
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Issued by __—� _—_-- Title
Date Completed —_ Inspected By __
nl 1 Lll,riPviv rUK N1'KEET EXCAVATION PERMIT 0" .e
f' TOWN OF SOUTH WINDSOR
� UBLIC TOWN DEPARTMENT
1540 SULLIVAN AVENUE
SOUTH WIDSOR, CT
FEE 25.00
Name of Firm Boutin & Sons Const . Co. 623-2526
Address of Firm Wl n s 0 ry 1 e o a Phone No.
roa Brook, onn
Location of proposed work 255 Sullivan v e
Describe fully nature of permit requested entrance apron e i n g r ado n g O a r l a O a
Starting date _
Call before you dig no. 20041600236 Approx.time for completion
Traffic Services Control No.
Show sketch of proposed work or furnish TO be fillet] out by TDWn Of So. Windsor
two copies of separate drawing
Pavement en_ t Cut
Indicate North jo
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 S
the Police Dept. and C.B.Y.D.
by date
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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.
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Signed: f Date: 4/13/04
Title /;
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
JO oc7
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Quote Good for 60 Days.
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
j Contract Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS.
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i CBUD Date
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