HomeMy WebLinkAboutDriveway Street Cut Permits 44 Simcka Dr 800157 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/05/08 w '»
GIS ID: 82800044
' FEE: 25.00
MUNIS APPLICATION# 200801381 EIRATION DATE: 09/05/09
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APPLICAl 'T 3 `LOCATION
NAME: BOUTIN&SONS � rs
y4,SIMKADRIVE
ADDRESS: 121 WINDSORVILLE IK1p Y, QR,, IIGIIESIRGINIA R
BROAD BROOK,CT'04( 1Si1G DRIVE
S4UT.H WINDSOR,CT 06074
PHONE 860-623-2526
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APPLICANT AGREES TO FURNISH THE TQ:W `OF SOU- ,
.;,..,„ ;; '1 UNT'F 'B�SND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY�I XI N ES° TC -:tr''H�,.To. t>F..OP MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE t l:PI,AIMN;T ISt I " V TH A TD I L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SDI TlL.�V >t1 S .' 3 Tl?� ,CfJT IT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
9/5/20088:34AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: �00 1 S 7 CONTRACTOR:
LOCATION: L4 y 5 nn r r A S r i VIP
TYPE OF WORK:- -Dr v e Loa-
DATE INSP NEEDED:
DATE INSP:
INSPECTED BY: 13
WORK IN
PROGRESS: boA
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AS-BUILT:
INPUT: DATE: - O
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 EINDS OOR, CT
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623-2526
Address of Firm 121 Windsorvi e Roadroa rook, Conn
06016
Location of proposed work 44 Simcka drive
Describe fully nature of permit requested Complete did out of dri yM=, plit in =rnr-PRR am
rade roll and ave.
Starting date 3 08 Approx.time for completion 9/30/08
Call before you dig no. 2008-1502192 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit S by
Cash()Check#
�J> Cut size after Perm. Patch
` 7 1
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
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:
�iC� Date:
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Title: D.L.#
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PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES