HomeMy WebLinkAboutStreet Cut Permit 39 Highview Road 1000093 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
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DATE: 05/26/10 � = pa
GIS ID:43200039 � �
r FEE: 25.00
MUNIS APPLICATION# 201000630
ORATION DATE: 05/26/11
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APPLICAN ��OCATION
NAME: BOUTIN&SONS IIGHIEW ROAD
ADDRESS: 121 WINDSORVILLE2( � � gyp,RA
BROAD BROOK,CT b 6b
6411 tiEw RD
-1 MNDSOR CT 06074
PHONE 860-623-2526 gof '
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WORK DESCRIPTION: D R I V 4) Y � �� �� s :
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APPLICANT AGREES TO FURNISH THE TFQ S { ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANYVCRP- �§ cu
CONNECTION WITH THIS PERMIT AND THE MAINTENANCE OR REPAIR WORK IN
'LI T D L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S l Y I BS$' -(III PF IIT MANUAL.
ISSUED IrY DATE INS ECTED INSPECTED BY
5/26/20101:46PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.; d CONTRACTOR6: el
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LOCATION: v
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: de,d//
INSPECTED BY:
WORK IN
PROGRESS: - L vr);� o
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES {] NO
AS-BUILT:
INPUT: w- DATE: f1
w12007 Town of South Windsor INPSECfION REPORT.07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC' WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Const. Co. Phone No. 623-�2526
Address of Firm 121 Windsorvi e Roadroa rook, Conn
06016
Location of proposed work----a Highvi Pw Road
Describe fully nature of permit requested Strip.Axi gti nS ciri-,raWay,dronSS With gravel—gzade, roll
anal nave_
Starting date Approx.time for completion
Call before you dig no. 20102102209 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled Out by Town Of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Wr Lt aJ Prop.size of cut
No.cuts
Amt.of Deposit S by
Cash(?Check#
Cut size after Perm. Patch
No.Cuts
l Final Billing S
Amt.Due Payee S
Amt.Due Town.$
Applicant is respon ble 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: 5/21/10
Title: Secretary D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES