HomeMy WebLinkAboutStreet Cut Permit 105 Country View Drive 1000176 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
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DATE: 08/26/10 �� -
GIS ID:24300105 'r := FEE: 25.00
MUNIS APPLICATION# 201001129 s _ y IRATION DATE: 08/26/11
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APPLICANT y - = LOCATION
NAME: BOUTIN&SONS RED 10 CO TRY VIEW DRIVE
ADDRESS: 121 VVINDSORVILLEta TT EE J&KELLY L
BROAD BROOK,CTb66 ff
iiTRY VIEW DR
-, ITkV- NDSOR,CT 06074
PHONE 860-623-2526
WORK DESCRIPTION: DRIAM �,
APPLICANT AGREES TO FURNISH THE T QV& OUTH �AM3F(1 ,:ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANNE P 06! CU T1�IrT��JN I�1�I AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THEPJANt IA$ I AV L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SE2VT11 WJDS1� RIa3` PIIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
8/26/201010:41AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: l 066 / 7 CONTRACTOR: Ho tti k)
LOCATION: / OS C O U n tlZ y V l eLA)
TYPE OF WORK: _1) 1 \�-e wa q
DATE INSP NEEDED: DATE INSP: L11
INSPECTED BY: 8 D
WORK IN
PROGRESS: �` �
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: 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 $25.00
Name of Firm Boutin & Sons Const. Co. Phone No. 623-2526
AddressfofFirm 121 Windsor vi e Roadroa rook, Conn
06016
Location of proposed work 105 C'nnntr�z Vi Pw Drivip
Describe fully nature of permit requested Strip exi.Rtina drivawAy, arl�]. �S ggl�6��—s iadtz
roll and pave - -
Starting date Approx.time for completion
Call before you dig no. 20103402156 Traffic Services Control No.
Show sketch of proposed work or fu Wish TO be filled out by Town of So. Windsor
� Pavement Cut
• two copies of separate drawing '
•Indicat Nort
a.
Prop.size of cut '
u�
l S � No.cuts
Amt.of Deposit$ by
Cash(D Check#
SCut size after Perm. Patch
No.Cuts J
Final Billing$ "
I Amt. Due Payee $
Amt.Due Town$
,Applic-ant Is responsible for contacting
the Police Dept.and C.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOU H 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 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.
Date. 8/19/10
Signed:
Secretary D.L.#
Title:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES