HomeMy WebLinkAboutStreet Cut Permit 88 Cadbury Lane 1000219 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/18/10
GIS ID: 15900088 ��� �' - FEE: 25.00
MUNIS APPLICATION# 201001413 s ' ERATION DATE: 10/18/11
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APPLICAN ==LOCATION
NAME: BOUTIN&SONS of f REV 8&CADF�URY
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ADDRESS: 121 WINDSORVILLEZQ � F . ICHARD D&REBECCA
BROAD BROOK,CT 06 al r _ - � D14JRY
a '' ' J TVINDSOR,CT 06074
PHONE 860-623-2526
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WORK DESCRIPTION: DRIVt TM
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APPLICANT AGREES TO FURNISH THE Tbgyo SOIJTH �y �AMq�T TU ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI' Isla CU � (�4 I'q F s- MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE ' IrAIaI I�Fn1IA �AI L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S �JTI��RimsR��TREET�U�P IT MANUAL.
ISSUED BY DATE INS ECTED INSPECTED BY
10/18/20108:37AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 1)h 0 a A3 CONTRACTOR:el
LOCATION: O Cqd�,q
TYPE OF WORK: ) � W
DATE INSP NEEDED: DATE INSP: )/
INSPECTED BY: 3h
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: 3 1
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 $25.00
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623-2526
Address of Firm 121 Windsorville Road roa rook, Conn
06016
Location of proposed work _AR Caribury Tang
Describe fully nature of permit requested g t r i P .A X i c t i n Q d r_;17@-4,7&y di Q, out lawn .
reft-
adci gavel_ grade _ rol l and pa' ua
Starting date Approx.time for completion
Call before you dig no. 20104901 R 1 h Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
A,r-a-
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit S by
501 f
OCash OCheck#
f Cut size after Perm. Patch
No.Cuts
1 i LLi�W N Final Billing$
Amt. Due Payee 5
' Amt.Due Town S
f� t
Applicant is responsible for contactingl
the Police Dept.and C.B.Y.D. —� by date
I 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:
10/14/ln
Seexetary
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES