HomeMy WebLinkAboutDriveway Street Cut Permits 74 Tumblebro TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3823 ConL:ra`c'tbr BOU'I'2`I;T":;&,. SONS
Location 0074 TUMBLE BROOK DRI Addr.:ess ,' 12� :WINDSOI2UILLE ROAD
Type Work DRIVEWAY BROAD'"BRk76K;,CT':<;,06016
Pho.ni�i No ($;SO)623' 2526<:
Date Insp Needed _ Da�e,::Snsls
Time Insp Needed ----- _ Time ZSt � —
Inspected By
Work in Progress
Input... Date --- � --o
Permit No. 3823 Town of South Windsor, CT
Date 08/16/2004 Street Excavation Permit
Expiration Date 08/16/2005
Descrip:
Applicant LocaC <an
Name BOUTIN & SONS b0 74.,.TUMBLE R6QK, DRI
Addr. 121 WINDSORVILLE' ;ROAD
BROAD BROOK CT 0601 Type of.Elok "pFiTVEWFIY
Phone (860)623-2526
Applicant agrees to furniA the:;Tonrn pt South Windsvx the amount of bond
required and to rejLmbizrse the::Tdw a Soua.th T�7xrs'klspr off' any' expenses
incurred by the Town fo'r maan`tenance or repair"'work :i,n cGnn:ecton with this
permit and that applicant I :Tamil 'a w G',h aid °wzll ,ablde>by the rules and
regulations for permits as gtrtlinefl; iz1 the Tatar` of South 'W;: 'ndsor's Street
Cut Permit Manual.
* * PERMI�TTQ BE kS PT ON.:.Q...-':SIfiE AT ALk. TI.FRSS.
Issued by
Date Completed Inspected B __ 4
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- WI,ORKS DEPARTMENT
1540 SULLLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm
Boutin & Sons Const. Co. 623-2526
Phone No.
Address of Firm 121 Windsorville Road Broad Brook Conn 0601
Location of proposed work 74 Tumble Brook Drive
Describe fully nature of permit requested Strip existing driveway; dress with process gravel,
grade, roll and pave
Starting date Approx.time for completion
Call before you dig no. 20043301411 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
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee S
Amt. Due Town S
Applicant is.responsible for contacting
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.
Signed:
G�%c% Date: � �a
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
I Description:
I �O 71? -�
3
Quote Good for 60 Days. ' r`� '�
Special Attention: 1/2 Payment Upon Starting, awe pon omp e i i � .
4 Contract Permit _
ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS.
CBUD Date
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