HomeMy WebLinkAboutDriveway Street Cut Permits 50 Henry Roa 800083 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 06/09/08
GIS ID•.41400050
MUNIS APPL IC
FEE:
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2 00 80 0 83 7
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06/09/0 9
APPLICANT
NAME ,. LOCATION
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SCRIPTION:
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APPLICANT AGREES TO FURNISH THEOF
THE TOWN O "' %rly1(3t}11T' I::BpI�tD REQUIRED AND TO REIMBURS
F SOUTH WINDSOR FOR ANY IXPTs11S"1TEUIp . ORrriAINTENANCE OR REPAIR WORK INE
CONNECTION WITH THIS PERMIT AND THE h'r`;h IC ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S6JRET L T':PEI{iVIIT MANUAL.
ISSUED BY
DATE INSP CTED INSPECTED BY
6/9/200810:41AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 90008,3 CONTRACTOR: 3oUl; 0
LOCATION: SO I Pn
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:_4z� _
INSPECTED BY:
WORK IN
PROGRESS:_
AS-BUILT:
INPUT: C �` DATE: �1
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC• WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Const. Co. Phone No. 623-2526
Address of Firm 121 Windsorville Road Broad. rook, Conn
06016
Location of proposed work 90 Henry Rond
Describe fully nature of permit requested- Strin .PxigtinQ rlrixrewgji dress with =oressarwz'-i
grade, roll and pave
Starting date 6/15/08 Approx.time for completion 7/15/08
Call before you dig no. 20082301944 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town of So. Wind;
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
(} Cash(}Check#
Cut size after Perm. Patch
No.Cuts
Final Billing $
Amt. Due Payee $
Amt,Due Town $
Applicant is responsible for contacting
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: d
Date:
Title: ��ler� T/ D.L.# ~
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
OFF GRAHM RD,
Job Location:
Description:
-5-3
Cl i
PLE'ASE 'NIOTE: DI-117 TO C'U'RRLIN"T VO.T.ATITAITY OF ',101-11E A')PIIALT PI�ICE
C 'i.
WIT LIL -' NY PLANT .\VI/N-l-ERI AL ARGFS
ONTR,�'\.CT PRICES BE S JBjECI i-'0 A
Quote Good for 60 Days. 01 IWIRM I
Special Attention: 1/2 Payme Up, ornpletio
,�nStartiing, Balance Upon C
Contract Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pres.
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Date
CBUD