HomeMy WebLinkAboutDriveway Street Cut Permits 268 Sand Hil 700023 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: n k.
04/11/07
GIS ID:79800268 "
FEE: 25.00
MUNIS APPLICATION# 200700427 :`
E ''IRATION DATE: 04/10/08
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AP PLI CA N T
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CAT I ON
NAME: BOUTIN&S - x> ,A
SONS <::.::.... ,<'yr ' .SANTJkHILLROAD
ADDRESS: 121 >: . .. :..;::.: : ..i.i:. �':.., .:'<
WINDSORVILLE.Rf3 ; 3 <"'ERt`.:;:.::';3 '..,
y 1�rIXT�DETER J&DEBRA K
BROAD BROOK CT L %`
x ... '`SAND'HILL ROAD
�. 'FI;W. SOR CT 06074
PHONE 860-623-2526
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SCRIPTION:
SCRIPTIO iceY �,` .•,��` k
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APPLICANT AGREES TO FURNISH THE TpWNAO S #J TI `' `. : >... :: .,; `"i., tea` i
�I ..:! .. A vI0iI 1 'OF1I36M REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI': N 9 TOWN F AQAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI` P AT 3T;IS;F A 1T1 ND;:. ?II,L:'ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IIN�/THE TOWN 4'sb 1TH.�V1Nl�SR>� �R�ET�II'�I?:ERi�1�MANUAL.
ISSUEDBY DATMNSP° TED INSPECTED BY
4/11/20073:20PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 7 on0 CONTRACTOR:
LOCATION: &Y -!�-tihd / ADDRESS:
TYPE OF WORK:_ 1),(\ Ue uja
DATE INSP NEEDED: DATE INSP:_ L/9 �6
INSPECTED BY: $b
WORK IN
PROGRESS: J-k
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 Cons t . Co. Phone No. 623-2526
Address of Firm 121 Windsorville Road Broad-7-rook, Conn 06016
Location of proposed work 268 Sand1 oa
Describe fully nature of permit requested n ,�„t l o wn areas , put -;n pr nr e s s_g,�y1�1
grade and roll and nave whole driveway.
Starting date Approx.time for completion
Call before you dig no. 20071402443 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of JO 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
the Police Dept.and C.B.Y.D. by date
1 AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS
PERMIT AND THAT l 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:
G G�GvsLl Date.
Title: de D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
JOD LOCa-rlo-n.
Description: ,n A i
60
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0
71
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PL TE: DUE TO CURRENT VO l� f/CdG
LATILITY OF LIQUID ASPHALT PRIGS,
CONTRACT ACT PRICES WILL BE SUBJECT TO ANY PLANT MATERI
AL CHARGES.
Quote Good for 60 Days.
• Mastercard Accepted
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion. �Z7/d
Contract
Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pres.
CBUD ' �
Date c5 1-7 Y61a If