HomeMy WebLinkAboutStreet Cut Permit 47 Scantic Meadow Road 1000065 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER _ STREET CUT PERMIT
DATE: 04/28/10
GIS ID: 81000047 = - , ,. FEE: 25.00
MUNIS APPLICATION# 201000,
466
�sOUNME
,aATION DATE: 04/28/11
APPLICAN LOCATION
NAME: BOUTIN&SONS - T IC MEADOW ROAD
ADDRESS: 121 WINDSORVILLE ( II ER f MARMTI SHANNON
BROAD BROOK,CT '? C MEADOW R
- J I SOR,CT 06074
PHONE 860-623-2526
WORK DESCRIPTION: DRIVEAY
APPLICANT AGREES TO FURNISH THE TO c k_)v*W - E'� ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E 1VE1N _4 IVIF F MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APP - I X _ ILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOU T ERMIT MANUAL.
VrD Ilv
ISSUED BY DATE INS ECTED INSPECTED 9Y
4/28/20109:46AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
Uri It NttUtU: DATE INSP
INSPECTED BY: h
WORK IN
PROGRESS: Lek �k
SEPTIC TANK PUMPED, SMASHED, FILLED:-- WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: CON DATE:_
W/2007 Town of South Windsor INPSEMON REPORT 07
•L oD�s
APPLICATION FOR STREET EXCAVATION PERMIT ' P °"
fe TOWN OF SOUTH WINDSOR
AWI• I'Jv • 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 Windsor e Roa roa rook, Conn 06016
Location of proposed work j Sa p t'mn pryant
Describe fully nature of permit requested
Starting date Approx.time for completion
Call before you dig no. ` n 1 0 1 CQ& u y Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled Out by Town Of So. Winds01'
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit S by
(?Cash M Check#
Cut size after Perm. Patch
No.Cuts
Final Billing $ '
Amt. Due Payee $
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 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: U
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES