HomeMy WebLinkAboutDriveway Street Cut Permits 736 Graham R 700172, TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/09/07
GIS ID: 37500736
FEE:
MUNIS APPLICATI 0701650 25.00
P' T,Ti�A IO N DATE:
1 0/0 8/08
:
APPLICAN'
LOCATION
IN&SONS
ADDRESS: 12
>,..
.... : TAM ROAD
NAME: BOUT :1 WINDSORVILLE:RAD�`.>.'~'�� �<�•�
ID R&NATALIE
BROAD BR
OOK,C T;0si5.
�6
>ij:::
3 1.LVl IG
I?�<H.. ROAD
T H WDSOR CT 06074
PHONE60-
8 62 3-2 52 6
z`
WO
RK
RK DES
CRIPTION:
CRI PT IO N:
D RIV E�
APP
LICANT AGREES TO FUR
NISH THE TC7�yVN'-'0-F Wig.
::.,,, .I3QND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY'EXPT�SS�:. QJ, OR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THE 1'lu3ANI rS •AITAI : I'�PID`WI:I L IDE BY THE RULES AND REGULATIONS
AB
FOR PERMITS AS OUTLINED IN THE TOWN OF SC3Li7IR S; TR "I CT€T=PEIVIIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
10/9/20073:53PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 8Ol73 CONTRACTOR: ot,c Aj
LOCATION:_- 73(o ra ha-y OQ oe
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
Ole-
AS-BUILT:
INPUT: GUy`" DATE:__
W/2007 Town of South Windsor INPSEC RON 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 Roa roa rook, Conn
Location of proposed work 736 C;r ham Road
Describe fully nature of permit requested strip existing driveway and widen to road add gravel as
needed, grade, roll and nave.
Starting date Approx.time for completion
Call before you dig no. 20074003123 Traffic Services Control No.
. 0 t
Show sketch of oposed work or fu ish To be filled out by Town or"So. Windsor
two copies of sep ate drawing Pavement Cut
Indicate North Prop.size of cut
I , No.cuts
Amt.of Deposit S by
1
1 O Cash O Check#
t
Cut size after Perm. Patch
I �l En No.Cuts
1 1
U l t Final Billing S '
1 Amt. Due Payee S
2 Amt.Due Town S
Applicant is responsible for contacting ( .
the Police Dept.and C.B.Y.D. No W�2 �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��i't-uG Date•
Title: /4-4fGI D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES