HomeMy WebLinkAboutDriveway Street Cut Permits 40 Sunnyside 700178 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 10/24/07 s
GIS ID: 88200040 !
MUNIS APPLICATION# 2 ;_: ..: >:< '`'''' FEE:
00701743 25.00
>B _:;
-AT ION
O N DA
TE:T E•
1 0/2 3/0 8
APP
LICANT.,C A NT
.. . . ....:........ .
::. .::: : . ...
BOUT ` < ><' .
NAME: IN&SONS LOCATION
!,.:: . .
UNNI IDE DRIVE
ADDRESS: 121 WINDSORVILLER0AD ,...,.ii:.ii.:.. ..:...::....
`"Q ED FUG- ER JEFFREY J&LISA A
BROAD BROOK,CT 06016 ; . ; .;' � f
4 N—Y-a, I
TJ - DE DR
IVE V E
PHONE 4UTH<>...
E 860-62 WINDSOR CT 06 3-2526 074
f :
WO
RK
DE
SCRIPTION:
S C RIP T I O N: .
D :
;
APPL
ICANT
CA N T AG
REES
RE E ST O FU
RNISH
R NI SH TH
E
EEITH-W N. V.THE TOWN OF SOUTH WINDSOR FOR 1OUN `QOI REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE 1IS .INLk,3 '' ` Q? 1�1 FDR;M. INTENANCE OR REPAIR WORK IN
a
APPT1NT> ., 7I <pl�} L "ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF STYT:,
C
ISSUE STktt Cfi 7� MANUAL.
Z RnII'I
D BY 7
DATE INS ' CTED INSPECTED BY
10/24/2007 11:35 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
1..4
114,
14.
sh<»
i: :..:
>y nx
i
Yf..
..
waia
j'Y
r'
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO,: -7 6-01 7Y
CONTRACTOR:_ 6c)
LOCATION: )
-TYPE OF WORK: D 't v f ,t
DATE INSP NEEDED:
DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
AS-BUILT:
INPUT: ��--
DATE:_
W/2007 Town of South Windsor INPSEMON REPORT 07
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 roa rook, Conn 06016
Location of proposed work 40 Dri vA
Describe fully nature of permit requested_ Stri= Pxi S t i n4 rir� i ETA r_ on ram ral 1 and navA
Starting date Approx.time for completion
Call before you dig no. 20074103470 Traffic Services Control No.
Show sketal of proposed work or furnish To be fiffled out 1-1-V T,.mm o vs f So. Winds-or-or
vr'it
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit S by
0 f� Come, Te () Cash()Check#
Cut size after Perm. Patch
>� No.Cuts
'✓ Final Billing $
Amt. Due Payee S
Amt.Due Town $
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 WJNDSOR 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 IN THE
TOWN OF SOUTH WINDSOR's STREET CUT PERMIT MANUAL.
Signed: Date:
1,4 f
Title: C ✓_ /�z�iy D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES