HomeMy WebLinkAboutDriveway Street Cut Permits 78 Dogwood L 800035 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 04/08/08
GIS ID:28500078
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FEE
:
25.0 0MUNISAPPLICATION# 2008 406
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PLICANT P L I C
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NAME: �G.i: LOCATIO
N&SONS
SS: 121 WINDSO :.'.07 .vf.. ! ()OD LANE
BROAD BROOK,CT f (I", � �RU�R GARY A&NARDA L
Dom..
OOD LANE
PHONE 86 623-2526
' WLVDSOR
,CT 06074
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SCRIPTION:
S C RI P T IO N•
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APP
LICANT
LIC A N T AG
REES
RE E S TO
FU
RNISH S H
THE T �O
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THE TOWN OF SOUTH WINDSOR FOR ANYMGtW'9, PE1SF 'FNTj > T Off;BD REQUIRED AND TO REIMBURSE
MAINTENANCE OR EPAIR WO IN
CONNECTION WITH THIS PERMIT AND THE A?PVdi 1I 'I I$`""Pi�Ita 4R>�pY�.� 'W�� ABIDE Y THE RU LES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S( U H I I3 Rz5 T' L T-%U: IIT MANUAL.
ISSUED BY
DATE INSPECTED
4/8/20081:36PM *** PERMIT TO*
BE KEPT ON JOB SITE AT ALL TIMES*** INSPECTED BY
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 'S 00 0-4--'5 CONTRACTOR: l ,n►�- +, 1J
LOCATION: ^1 � G ► �r'���
TYPE OF WORK: D� \,�-e uo c
DATE INSP NEEDED: DATE INSP: /F /6 a
INSPECTED BY: p
WORK IN
PROGRESS: i`�e��--e_ / act �
AS-BUILT:
INPUT: G DATE: b d
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT �c�
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 060115
Location of proposed work t L ro le-4
Describe fully nature of permit requested bri
Starting date Approx.time for completion
Call before you dig no. 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
GM
No.cuts
I
. Amt.of Deposit 5 by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
s
1 Final Billing S '
Amt. Due Payee S
.OVT Amt,Due Town $
Applicant is response le 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 SOUTI WINDSOR's STREET CUT PERMIT MANUAL.
Signed Date-
Title: D.L.# ~
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES