HomeMy WebLinkAboutDriveway Street Cut Permits 301 Abbe Roa 700140 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/04/07
GIS ID: 00900301
FEE: 25
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MUNIS APPLICATION# 200701419
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APPLICANT .z.ri z€
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ADDRESS: 121 WINDSORVILL �R4AID':3%�''�.,.�`•.F� r<��;>M
ROBERT M&TAKAKO Y
BROAD BROOK, ' " ' >'
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PHONE 86 0 62 3-2 52 6
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WORK DES
CRIPTION:
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APPLI
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NT AGREES TO
FURNISH THE T:.:
F QIIf�E1 ':A1VI( 1T' 3
F,139ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY"EXPtSEI`C[Jijz :: }y�Z J : QR 1!IAINTENANCE OR REPAIR
IN
CONNECTION WITH THIS PERMIT AND THE'APpLICAI�iI Y�R T�� [H. E ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S't 1 TT W-IND STRFL 1 CAI T,:p I 1IT MANUAL.
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ISSUED BY DATE SPECTED INSPECTED BY
9/4/20073:36PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: .i 60 CONTRACTOR: c
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LOCATION: ADDRESS:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: z r oq
-INSPECTED BY:
WORK IN
PROGRESS: L®o CU4_
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INPUT: DATE:
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APPLICATION FOR STREET EXCAVATION PERMIT
N OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
�• TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Const. Co. Phone No. 623-2526
Address of Firm 121 Windsorvi e Road- roa rook, Conn 06016
Location of proposed work - 01 Abhp Road Fxt
Describe fully nature of permit requested_ Strip xiG ing drivPwa5. dig rnit lawn arPa, brad
roll
Starting date 9 15/ 7 Approx.time for completion 15/15/07
Call before you dig no. 20073402653 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town of SO Windsor
two copies of separate drawing nn Pavement Cut
Indicate North l Prop.size of cut
I.. No.cuts
Amt.of Deposit$ by
(1 Cash O Check#
Cut size after Perm. Patch
1 + V 1 No.Cuts
l9 _J
I Final Billing$
DAmt. Due Payee S
Amt.Due Town $
Applicant is res nsble for contacting
the Police Dep .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 1 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: 41
Title: C D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES