HomeMy WebLinkAboutDriveway Street Cut Permits 90 Beelzebub 700125 TOWN OF SOUTH WINDSOR CT
-PERIvIrT NUMBER STREET CUT PERMIT
DATE: 08/08/07
GIS ID: 09000090
•i.3<>i
<yl MLJNIS APPLICATION# 200701243 "' ""$` " ...E"
FEE: 25.00
',' XPIRATION DATE: 08/07/08
A :,.•:.
PPLICANT u::: <_;
OCA
,i:
"`L TI O N
NAME:
BO LT IN&SON
....
<.
ADDRESS: 121 WINDSORVIL ''
S ��}0'�EEL,Z�BUB ROAD
LE ROAD ''..';::.:.::.,,;:::',.::. uWIN
G IAMES R ELDA B
BROAD BROOK CT . L BUB ROAD
00
T
.Hi..
SO'.�.� . WIND
CT 06
074
4
PH -
7
ONE
860 623-2 ,..52 6
WOR
K DESCRIPTION:
D RIV Ia s
i .;
.. .:<.:. .::: :+::;i:tl
APPLICANT AGREES TO FURNISH THE TbWN OF>:SC1€ITI .; I ;: ^per;;>gEQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI,.EEN INC 11 "i : OWk1 O :;IyT4ITENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI` 1 tIC °Is A t1NDBIDE BY THE RULES AND REGULATIONS
FOR PERMITS
A�—S OUTLINED IN THE TOWN OF'SaV' ,WTP4D5�'S E�' FJT,PF�11fIT;I�TANUAL.
V � • „ .:.: �of !"'4y..�MpN...
ISSUED BY DATE IlT ' INSPECTED BY
8/8/200710:25AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Old,�— CONTRACTOR: D
- LOCATION: Z�
TYPE OF WORK: �r .t v,-e u0R,
DATE INSP NEEDED: DATE INSP. i 18
INSPECTED BY: fif�
WORK IN
PROGRESS: �Colo C�
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
1540 SULLIVAN.
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623-2526
Address of Firm 121 Windsorvi e Road roa rook, Conn Olson
Location of proposed work 90 Beelzebub Road
Describe fully nature of permit requested_ Stri r�.Pxi�ti n� dri v1-WgU add zravP1 , C7YaC�P rn�1 ape jgaCTP
Starting date 8/15/07 Approx.time for completion_ g/1 5/J07
Call before you dig no. 20073102437 Traffic Services Control No.
Show sketch of proposed work or furnish TO_be filled out by Town Of SO Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
pp,� No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
2 j Final Billing$
Amt. Due Payee $
Amt. Due Town $
Applicant is responsible for contacting
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 WJVDSOR 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 H THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: G
Date:
Title: T D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES