HomeMy WebLinkAboutStreet Cut Permit 30 Scott Drive 900121
PEERMITRMIT NUMBER TOWN OF SOUTH WIND
S O R, CT
. :� STREET CUT PERMIT
DATE: 09/14/09
GIS ID: 8160003021
MUNIS APPLICATION# 200901091 FEE:
,p�'t1,: p�:s' ✓ � t � '�., ! �•� F s °�.r a'• $, 25.00
3F'" s < •- {a t ; ,''' TION DATE: 09/14/10
APPLIC .:<..::`.:;
N BOUTIN&SONS ° {::. LOCATION
ADDRESS: 121 WINDSORVILLI A �� �. ~DRIVE
TIODRIVE
BROAD BROOK, " C�H.L WRENCE J&HELENE N
,CTO
PHONE a h ...
0-62 gr,-'
TI W OR
86 3-2526 .. S CT 06074
WORK DESCRIPTION: DRIV�W N n
APPLICANT AGREES TO FURNISH THE T61N�" F�W"' u ' T �3ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY y
B.
E`XE� • � 'OI2sIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE ''LI AF J x ...IT� D' 1T L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SNUT42&
' T E Imo. I' IT MANUAL
ISSUED BY �
DATE INSPECTED INSPECT BY
9/14/200911:33AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 00 Jo2 CONTRACTOR: O
(.r /lJ
LOCATION: U C� "Sray-J
TYPE OF WORK: D I Q-e
..DATE INSP NEEDED: DATE INSP: !Z//7 09
- _ INSPECT ED-BY: 6 D
WORK IN
PROGRESS:
AS-BUILT:
INPUT: CGS DATE:,J;a - 0
W/2007 Town of South Windsor INPSECTION REPORT 07
,� 0090) oR
APPLICATION FOR STREET EXCAVATION PERMIT .
TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN.AVENUE
SOUTH WINDSOR, CT
FEE $25,00
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623=2526
Address of Firm 121 Windsorvi e Roa roa rook, Conn 06016
Location of proposed work____3n Sen1 t T)r•i 7P
Describe fully nature of permit requested Stri n Pxxi ct i nag rlri 4�w�,
Starting date 9/21/09 Approx.time for completion 1n/21/!lA
Call before you dig no. 20093603463 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town of So. Windsor
two copies of sepa ate drawing Pavement Cut
Indicate Nort•1 Prop.size of cut
O
t No.cuts
7 Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
f No.Cuts
V1 Final Billing $
' Amt.Due Payee S
Amt.Due Town S
Applicant is response le for contacting
the Police Dept.and 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:
9/8/09
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES