HomeMy WebLinkAboutDriveway Street Cut Permits 46 Tumblebro TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2937 t Contractor BOUTIN & SONS
Location 0046 TUMBLE BROOK``DRI Address 121 WINDSORVILLE ROAD
Type Work DRIVEWAY BROAD BROOK CT'Q,6016
Phone No. (860)623-2526
Date I nsp Needed ,I nsp
X
Time Insp Needed 71m8: Insp.
Inspected By __—
Work in Progress ----------_—._---
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Input Date
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Permit No. 2937 (-own of South Windsor, CT
Date 03/29/2000 Street Excavation Permit
Expiration Date 03/29/2001
Descrip:
Applicant Location
Name BOUTIN & SONS 0.0.46 TUMBLE BROOK DRI
Addr. 121 WINDSORVILLE ROB, ,- :
BROAD BROOK CT 0601 T�p� of. Wick DRIVEWAY
Phone (860 )623--2526
Applicant agrees tn` fur"n, i ;'ohs ,Town `` f South ,W;i ndsor the amount of bond
required and to reimbu�Se .-thQ 'own of 666th W ,400, 7 for any expenses
incurred by the Town fer n**, htenanc� ®r repay r w€�►�k i n connection with this
permit and that appl scant is ;fame 1 ,an, W >i�'h an�rwy`I i abide by the rules and
regulations for permits a� oU, �n # Tows =`t?f, South Windsor' s Street
Cut Permit Manual .
dd
RMIT IO aE KEPT ON SITE AT 'ALL TIMES.
Issued byDate Compiet � � ispected By --
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN-HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm f —Phon N
Address of firm
Location of proposed Work-7
Describe fully nature of permit requested
Starting date Approx.time for completion
Call Before You Dig Noc=U2 Traffic Services Control No.
Show sketch of proposed work or furnish To he filled out ft-Town of$guth Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
,U ! No,cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt.Due Payee$
Amt. Due Town$
Applicant is responsible for contacting by date
the Police Dept.and U Y.D.
I AQP.EE TO FURNISH TO THE TOWN OF SOUTH WIND T14E AMOUNT OF.BEND RE(jt1IRED AND TO''REIMi3URSE THE TOWN OF
SOUTH WINDsOA�FQRANY 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:
Date: vw
Title: D.1:.#•
PERMIT SHALL BE KEPT ON JOBSItE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc