HomeMy WebLinkAboutStreet Cut Permit 57 Scantic Meadow Road 1000085 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/17/10
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GIS ID: 81000057 77
FEE: 25.00
MUNIS APPLICATION# 201000578e y
y � �IRATIONDATE: 05/17/11
APPLICAN'1 _ I LOCATION
NAME: BOUTIN&SONS of f 7 s� ✓
ADDRESS: 121 WINDSORVILLE21 J y /11 � y� SCAM MEADOW ROAD
s i1 AYMOND J&JOAN A
BROAD BROOK,CT�66 .. 1IC MEADOW R
�OJFVINDSOR,CT 06074
PHONE 860-623-2526 /����
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WORK DESCRIPTION: DRIN -V
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APPLICANT AGREES TO FURNISH THE Tf%V�F" ITH$ � Z OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI 5klN'SL �C - - W AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE PL '' &�T AL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF Q - _4 . ST; T T SUM IT MANUAL.
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ISSUED BY DATE SPECTED INSPECTED BY
5/1 7/20 10 9:24AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Z0000 S5 CONTRACTOR: 60 Ott
LOCATION: -S(a V-)-\l c
TYPE OF WORK: T I v---e
DATE INSP NEEDED:. DATE INSP:_J�L4 'jJ
INSPECTED BY: I�fl
WORK IN"
PROGRESS: f7�•, - �r� (:GL
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED F] YES [] NO
AS-BUILT:
INPUT: C DATE:-
W12007 Town of South Windsor INPSEMON REPORT.07
APPLICATION FOR STREET. EXCAVATION PERMIT
OWN OF SO 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 Roadroa rook, Conn
Location of proposed work 97 Srantir- M2a(JOW Rnad
Describe fully nature of permit requested Strip existing drive-wad dress Wrth pro QSS—s��I'
P,rade, roll and pave.
Starting date Approx.time for completion
Call before you dig no._ 20102003083 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town of So. Windsor
two copies of separate drawin Pavement Cut
f-,
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit S by
Te Cash OCheck#
Cut size after Perm. Patch
No.Cuts
Final Billing S '
M
• Amt. Due Payee S
Amt.Due Town S
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:
�12,e Date:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES