HomeMy WebLinkAboutStreet Cut Permit 53 Kelly Road 900047 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER ,
STREET CUT PERMIT
DATE: 05/11/09
GIS ID:49500053 �yx � °" 4 �w
MUNIS APPLICATION# 2009004 `' ` J$ ' . FEE25.00
:
. . ...#. f• ,,=a ✓_ ;' ,t. '�RATIONDATE: OS/11/1
.., �`.. ` ,, f 0
APPLICA f Y `
NAME: BOUTIN&SONS " ' OCATION
ADDRESS: 121 WINDSORVILL A S § ROAD
.
BROAD BROOK,C ` 0 1 A " 3 WT ON.THERRIEN NANCY R&
_. u... ROAD
PHONE 860-623-2526 k } x _ '.r: , , TI3 NDSOR,CT 06074
f�
}:
WORK DESCRIPTION:
APPLICANT AGREES TO FURNISH THE
THE TOWN OF SOUTH WINDSOR FOR ANON? BND REQUIRED AND TO REIMBURSE
Q., P y .0 �'' AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THEP�,�"` T •�` `•; :�� ''"'T .
FOR PERMITS AS OUTLINED IN THE TOWN OF SbI,TT '' LL ABIDE BY THE RULES AND REGULATIONS
. T fiNI IT MANUAL.
mo Ito
ISSUED BY DA E' S ECTED INSPECTED BY
5/11/200912:08PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 9 000V-7 CONTRACTOR:__ �600 fj!O
LOCATION: 3YpJA
TYPE OF WORK: v`Q rya.
DATE INSP NEEDED: DATE INSP: 8
INSPECTED BY:
WORK IN
PROGRESS:
AS-BUILT:
INPUT:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT r `
TOWN OF SOUTH WINDSOR
PUBLIC• WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623-2526
Address of Firm 121 Windsorvi e Road Bro'aa. Brook, Conn 06016
Location of proposed work 5 3 K P 1 1 y R n n rl
Describe fully nature of permit requested Widen. driyeWay by road strip tiirnnrnnnd
add Rravel, grade, roll and pave.
Starting date 6/1/0 9 Approx.time for completion ]/1,0 9
Call before you dig no. 20091803461 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town Of So. 'Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
l�. O Cash{)Check#
h Cut size after Perm. Patch
No.Cuts
b U Final Billing$ '
v_
Amt.Due Payee $
7l Amt.Due Town $
Applicant is responsible for contacting
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 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: Date. •y �.
Title: �r D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES