HomeMy WebLinkAboutStreet Cut Permit 41 Palmer Drive (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 9 o D I H a- CONTRACTOR: Po y -r i n
LOCATION: 41 pal M e�- bf'o v e
TYPE OF WORK: of u
DATE INSP NEEDED: DATE INSP: t 2 /a2 og
INSPECTED BY:
WORK IN
PROGRESS:
1Jo
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
900142 TOWN OF SOUTH WIND
PERMIT NUMBER S O R, C T
STREET CUT PERMIT
DATE: 10/21/09 NN
GIS ID: 68400041
MUNIS APPLICATION# 200901292 y "°� FEE: 25.00
s, y Y .
IRATION DATE:
x 10/21/10
APPLICANT
NAME: BOUTIN&SONS �.. y .. '. ' 3 LOCATION
ADDRESS: 121 WINDSORVILLE sa �.�� PALIER DRIVE
R� OBE
BROAD BROOK,CT ftel�...r K V KI MARY C
R DRIVE
SAT E PHONE 860-623-2526 VINDSOR,CT 06074
WORK DESCRIPTION: DRILL r.AA
APPLICANT AGREES TO FURNISH THE TfjpF�OIJ , 2 :: >
THE TOWN OF SOUTH WINDSOR FOR ANi SF C:> TEE �REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE& z WFAINTENANCE OR REPAIR WORK IN
FOR PERMITS AS OUTLINED IN THE TOWN OI? CtN�YS 1� LL ABIDE BY THE RULES AND REGULATIONS
� ..' S S S IIT . IT MANUAL.
ISSUED BY >#
DATE INSPECTED INSPECTED BY
10/21/20093:05PM ' PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
0?00C31D)a APPLICATION FOR STREET EXCAVATION P 0® � `�a
TOWN OF SOUTH WINDSOR PERMIT -
PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623=2526
Address of Firm 121 Windsorvi e Roa roa rook, Conn 06016
Location of proposed work 41 Palmer Drive
Describe fully nature of permit requested Strip eNistinQ driveway dress with process P-ravel,
grade, roll and pave.
Starting date 11/15/09 Approx.time for completion 19/1/n()
Call before you dig no. 20094201473 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
�r Amt.of Deposit$ by
r O Cash O Check#
5 Cut size after Perm. Patch
No.Cuts
Final Billing$ '
Amt.Due Payee $
Amt.Due Town.$
Applicant is respo Fforcontacting I
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:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES