HomeMy WebLinkAboutStreet Cut Permit 41 Palmer Drive 900142 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 10/21/09
GIS ID: 68400041 '.;. .:;x
MUNIS APPLICATION# 200901292 ' ` <;,4` FEE: 25.00
IRATION DATE: 10/21/10
APPLICANT �� s z
NAME: BOUTIN&SONS j r :<< .: ` %LOCATION
4PALIVER DRIVE
ADDRESS: 121 WINDSORVILL��flA¢D O E
BROAD BROOK,C 3 k h I KI MARY C
®1 ' ' ' "
f„ x R ATIR DRIVE
PHONE 860-623-2526 NTH) INDSOR,CT 06074
WORK DESCRIPTION:
DRI h y `a .
APPLICANT AGREES TO FURNISH THE O } b �` "
THE TOWN OF SOUTH WINDSOR FOR AN ., A E BEND REQUIRED AND TO REIMBURSE
EA AC' 04 VP
AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THErXf'SCANN I y
FOR PERMITS AS OUTLINED IN THE TOWN OF SO l �D FILL ABIDE BY THE RULES AND REGULATIONS
SW ST UT EIItMIT MANUAL.
Cl '1/YIDI to
ISSUED BY
DATE INSPECTED INSPECTED BY
10/21/20093:05PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 9 ®D ► q a- CONTRACTOR: Po ko-'i n
LOCATION: 4 I
TYPE OF WORK: of
DATE INSP NEEDED: DATE INSP: or
INSPECTED BY: 4D
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: _ DATE: /c
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION -
TOWN OF SOUTH WINDSOR PERMIT
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 Windsorvi e Roadroa . rook, Conn06016
Location of proposed work 41 Palmer Drive
Describe fully nature of permit requested Strip existing driveway dress with process gravel,
grade, roll and pave.
Starting date 11/15/09 Approx.time for completion
Call before you dig no. 20094201473 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 8 by
O Cash(?Check#
5-
Cut size after Perm. Patch
No.Cuts
Final Billing $
Amt.Due Payee $
Amt.Due Town S
Applicant is respo Ffo�rcontacting I
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 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•
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES