HomeMy WebLinkAboutStreet Cut Permit 98 Dogwood Lane 1000177 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/26/10
GIS ID:28500098 _0
MUMS APPLICATION# 201001130 ��: ' FEE: 25.00
y - IRATION DATE: 08/26/11
LICAN � �� �� ���
APP � � LOCATION
NAME: BOUTIN&SONS - ��'.RE
� 9 DOGOOD LANE
ADDRESS: 121 WINDSORVILLE -z �wo 1 9 S EDNA
BROAD BROOK CT 66 `
' OOD LANE
PHONE 860-623-2526 )VINDSOR,CT 06074
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WORK DESCRIPTION: DRIVjWI'
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APPLICANT AGREES TO FURNISH THE T OITH' AM( REQUIRED AND TO REIMBURSE
f �$,
THE TOWN OF SOUTH WINDSOR FOR ,EC _ - �"�W1�I � = AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE ; A L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFpfTVg�€DSZ - IpIT MANUAL.
�J2a/10 _
ISSUED BY �
DAT PECTED INSPECTED BY
8/26/201010:52AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Z 060 l 7 7 CONTRACTOR:__ 8641>A2
LOCATION: La v_�
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: QO
WORK IN
PROGRESS: LDS 6k
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: W\ DATE:_)
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
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 Road---- Broad. rook, Conn
06010
Location of proposed work
Describe fully nature of permit requested Strip. exieti ng driveway, dress
grade roll and ave.
Starting date Approx.time for completion
Call before you dig no. 20103400525 Traffic Services Control No.
Show sketch of proposed ork or furnish TO be filled out by Town of So. Windsor
g Pavement Cut
two copies of separate dra in
Indicate North Prop.size of cut
No.cuts
r f Amt.of Deposit 5 by
1
5�/L1� ✓ �� (?Cash O Check#
/U i v v Cut size after Perm. Patch
No.Cuts
1
�. Final Billing S
Amt.Due Payee $
4/_ �� Amt.Due Town S
Applicant is responsible for c ntacting
date
the Police Dept.and C.B.Y.
1 AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SOUTH W}NDSOR 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.
Date: 8/1.8/10
Signed:
Title:
ieCretary D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES