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HomeMy WebLinkAboutDriveway Street Cut Permit 39 Glenwood D 700094 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 06/22/07 .3 GIS ID: 35700039 FEE: MUNIS APPLICATION# 200700953 P± 25.00 �PIRATION DATE: 06/21/08 APPLICANT ».......; ` ...::,:.:....l; W ..o f LOCATION NAME: BOUTIN&SONSROAD3 ;RE .91", 39 LN OOD ADDRESS: 121 WINDSORVILLE.Ro .<::<:;>;. : `°,:,.:..<•v ;:. ` `,;.: �.k:; f 1 f ,.:;...:".:. RCQI�*EDWARD J&DOROTHY J BROAD BROOK,CT 066% ?'' `:fsL NW'O ` OD ROAD W,» DSOR,CT 06074 PHONE 860- 252 623- :6 WO RK DE SCRIPTION:GRIP TION: �....RIV'EW APP LICANT NT AG REES ES TO FU RNISH NISH THE WN OI;:: . fi�� ;>�A!10I,TI^�`(''`�k'�BDN�REQUIRED AND.. , Q TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANI i,EMNSE$> UR t: (J ,j ECfR 1�I,Q�'TNTENANCE OR REPAIR WO .,:.f s :.»...... WORK IN CONNECTION WITH THIS PERMIT AND THi"t1PICAI : S'FAGItVII 2I�iFg hII L'ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OI''SQ1(IVS '>S«'°':TET"GL1 ARIA MANUAL. mo Now ISSUED BY DATElNSPECTED INSPECTED BY 6/22/20073:34PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: ©oV CONTRACTOR: 6011 LOCATION: J Ien000J Xo ADDRESS: TYPE OF WORK: 1 W U3 DATE INSP NEEDED: DATE INSP: a e �� INSPECTED BY: WORK IN PROGRESS: -INPUT: DATE: APPLICATION FOR STREET EXCAVATION PERMIT OWN 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 WindsorvilLeRoad oa rook, Conn 06016 Location of proposed work t a n�.in n rl R n a rl Describe fully nature of permit requested_ ('mm�1 P f P rl i Q n i i t of rj r i vP w g 17 f a ri r1 n r n n a c c s,..o x7n i grade, rnl 1 and r3avP _ Starting date 7 Z 1 /0 7 s Approx.time for completion R.Z Call before you dig no, 20072901225 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 -7U r ()Cash()Check# Cut size after Perm. Patch v No.Cuts �f] ��� w g /\ Puna!Billing s Amt. Due Payee s Amt.Due Town s Applicant is responsible for contacting the Police Dept.and C.S.Y.D. by-_L 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:- e`% Date: (Y Title: ✓ D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES