HomeMy WebLinkAboutStreet Cut Permit 50 Pheasant Way 1000104 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/22/10
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GIS ID:71100050 �� = FEE: 25.00
MUNIS APPLICATION# 201000757 � `
r AW �1RATION DATE: 06/22/11
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APPLICANTS y = ;LOCATION
NAME: BOUTIN&SONS R� 5(PHEANT WAY
ADDRESS: 121 WINDSORVILLEAI
BROAD BROOK,CT 6 6 y B4-!ANDREW&CAROL J
FI FA%ANT WAY
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�DJPVINDSOR,CT 06074
PHONE 860-623-2526j r
WORK DESCRIPTION: DRIV� Y= y � �
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APPLICANT AGREES TO FURNISH THE T -ow��Fs UTHJ'-- ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIXfSNC AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE PP � A1V L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF ITT �V35 ST '� rtlPIIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
6/22/20109:26AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:-100010 CONTRACTOR: 6_uq,)'tJ-
LOCATION: S r l(2a
TYPE OF WORK: c'\V`e UDQ
DATE INSP NEEDED: DATE INSP: r
INSPECTED BY: B b
WORK IN
PROGRESS: /1041
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED Ej YES ❑ NO
AS-BUILT:
INPUT:_ DATE: '
W12007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FORSTREET EXCAVATION PERMIT
N 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 Windsorville Road Broaa—Hrook, Conn 06016
Location of proposed work 50 Pheasant WU
Describe fully nature of permit requested Strip exist_driveway, dress with process gravel,
grade, roll anti navy
Starting date Approx.time for completion
Call before you dig no. 201025004h0 Traffic Services Control No.
Show sketch of proposed work or furnish TO be rilled Out by Town Of So. 'Windsor
two copies of separate jra,vving Pavement Cut
Indicate North Prop,size of cut
No.cuts
�. Amt.of Deposit 8 by
` O Cash O Check#
f Cut size after Perm. Patch
No.Cuts f
Final Billing $ '
Amt. Due Payee$
Amt.Due Town .$
Applicant is responsible or 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 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