HomeMy WebLinkAboutDriveway Street Cut Permits 79 Robert Dr r 700129 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 08/13/07
GIS ID: 76500079
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MUNIS APPLI E: 25 CATION# 2007012 00
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NAME: B CATION
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DRESS-":: ":39-P OBER> D
ADDRESS: 121 WINDS RIVE
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SCRIPTION:
SC RI P TI O N:
D RIVE
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APPLICANT AGREES TO FURNISH THE TbWN,.DP- <:>
OUI 1 OF 10� 0 REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY<EXNS INGZa; EATO{ F�R3MATENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE`�?�,PPS:Q.Al I `Ft v1T P;Z' rIT1 BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF7U TI1I7I2''S:: EU�s g MANUAL.
ISSUED BY 8
DA "NSP�D INSPECTED BY
8/13/20078:57AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 7 i5D 14 R CONTRACTOR:_
- LOCATION:_ -7 cj
TYPE OF WORK:__
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:_ bo v C G�1L
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
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 Boutin & Sons Cons t. Co. Phone No. 623-2526
Address of Firm 121 Windsorvi e Road roa rook, Conn 06016
Location of proposed work 79 Robert Drive
Describe fully nature of permit requested_ Strip.driveway add gravel as neeEled, grade, roll anC pave.
Starting date 8/15/07 Approx.time for completion 9715707
Call before you dig no. 20073201559 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
/W'I No.cuts
• �� P Amt.of Deposit S by
1 O Cash O Check#
s
Cut size after Perm. Patch
it No.Cuts
/� Final Billing S
Amt. Due Payee S
Amt.Due Town S
Applicant is responsible for contacting I v
the Police Dept. and C.e.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: Date• �' Q
Title: S�Gv���
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES