HomeMy WebLinkAboutDriveway Street Cut Permits 20 Robert Dr 700114 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
1 STREET CUT PERMIT
DATE: 07/25/07 > �a . .
GIS ID: 76500020
MUNIS APPLICATION > ; . FEE: 25.00
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>"' 'II4RATION DATE:
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AP PL I C A
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TION TI O NNAME: BOUT IN&SONS 9`
OBEIT DRIVE
BROAD BROOK CT 6 .3.:: CIA A MADOTT
ADDRESS: 121 WINDSORVILLE Wi
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NE 860-623-2 £`526 . 6076
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WOR
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APPLICANT AGREES TO FURNISH THE
OL OF )N1)REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN ':E7NIv >ICDPMJTENANCE OR REPAIR WORK IN
CONNECTION
RMITS WITH THIS PERMIT AND THI`1PP ILU:pBIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OPSOU'Trff) S1 '' E 1 jJ tj I MANUAL.
.£ ^....� ». <' .�: • ..>f-:;.
ISSUED BY DA'1Y >>SFE D INSPECTED BY
7/25/200710:34AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT-NO.:
. . CONTRACTOR:
LOCATION: �� �o:�r� J�r�use
ADDRESS:
TYPE OF WORK: 0C.0.
DATE INSP NEEDED:
DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
.INPUT: DATE: `
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 Const. Co. Phone No. 623-2526
Address of Firm 121 Windsorville Road roa rook, Conn
Location of proposed work 20 Robert nri re
Describe fully nature of permit requested RestIrface existinZ driveway,veway, dig wit t 'lawn wn area T
put in process gray 1 o new , grade, nl l and nave Pnti rP dri v wa)i.
Starting date Approx.time for completion
Call before you dig no. 2007290066 Traffic Services Control No.
Show sketch of proposed work or furnish To be i;lled out by'mown of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
a Amt.of Deposit S by
�6
O Cash O Check#
I
�j Cut size after Perm. Patch
® I No.Cuts
Final Billing S
Amt. Due Payee 6
Amt.Due Town S
Applicant is responsible for contactin
the Police Dept.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 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: ��/flil�l/ Date:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES