HomeMy WebLinkAboutDriveway Street Cut Permit 79 Andreis Tr 700084 TOWN OF SOUTH WINDSOR, CT
a PER[aIIT NUMBER STREET CUT PERMIT
DATE: 06/15/07
GIS ID: 03300079
FEE: 25.00
MUNIS APPLICATION# 200700903 `` ' '"`~t�`
IRATION DATE:
r�.. 06/14/08
APP LI C AN'I3`' :.
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'LOCATION
NAME: BOUTIN&SONS '' .:'
wv * '•, : 1NDRIS TRAIL
ADDRESS: 121 .:.:,
WINDSORVILLE.2(3 � « y'`..
E&JAYNE I
BROAD BROOK CT ''
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TDSOR,F 06074
PHONE ��.�...:.-
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SCRIPTION:
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APPLICANT AGREES TO FURNISH THE TOWN QP:$SQ
'BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI ; NS �II LgI; > .TQC'F( TENANCE OR N.
REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE>APPI :AMT, ANI3>Vt'II 4'kBIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUT/LINED/y►IN�THE TOWN OF`Soi7TMTg WII T ` " '.:.'.. °(j j 12 MANUAL.
cs� Y 1 to 1V ...
ISSUED BY DACE' SI' ED INSPECTED BY
6/15/200711:18AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: "o CONTRACTOR:
LOCATION:_?ct r�l - iv—Ls ADDRESS:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: 7 0
INSPECTED BY: _
WORK IN
PROGRESS: A
-INPUT:— i1'L DATE:_ 71F,67
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT 7 6)0C)&C
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 7() A n ci r P i S Tr n i l
Describe fully nature of permit requested_ g t r i n a y i c t-1 n c, ri r i-,Z�W-g rl r A c a
grade, roll and paye. ' -
r
Starting date 6./15/0 7 Approx.time for completion__ 7/1 9102
Call before you dig no. 20072301.188 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled Quit 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 J
the Police Dept. and C.S.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:
Title: p r p A f a Y V D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES