HomeMy WebLinkAboutDriveway Street Cut Permit 380 Abbe Road 1000046 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/05/10 .
GIS ID: 00600380 = FEE: 25.00
MUNIS APPLICATION# 201000323 TION DATE: 04/05/11
APPLICAN y X� OCATION
NAME: BOUTIN&SONS ROAD
ADDRESS: 121 WINDSORVILLE R. OR ROBERT J
BROAD BROOK, CT 616 ROAD
H- SOR,CT 06074
PHONE 860-623-2526
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WORK DESCRIPTION: DRIV AY -
APPLICANT AGREES TO FURNISH THE TO ld OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY E B MAINTENANCE OR REPAIR WORK IN
f
CONNECTION WITH THIS PERMIT AND THE AP I LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN�OnF SO T RMIT MANUAL.
w�j-)�J-u - c
IS
ISSUED BY DATE INSPECTED INSPECTED BY
4/5/201010:58AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /f T O Y( CONTRACTOR: Aowt/
LOCATION: 5�?C A6keOCc
TYPE OF WORK:_ _b Y 1 W cX)g'0
DATE INSP NEEDED: DATE INSP: 3 I o i
INSPECTED BY: a)
WORK IN
PROGRESS: L b!/�
VA
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ Y pp
AS-BUILT:
INPUT: DATE: C/-
W12007 Town of South Windsor INPSECTION REPORT 07
/6000
a?U I Oo b3�3 APPLICATION FOR STREET EXCAVATION PERMIT .
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN.AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Cons t. Co. Phone No.
623-2526
Address of Firm 121 Windsor,,oi Ra roa rook, Conn
Location of propnsPd work .��'! 'a
Describe fully nature of permit requested
Starting date d Approx.time for completion
Call before you dig no. C) Traffic Services Control No. _
Show sketch of proposed work or furnish TO be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North A Prop.size of art
No.cuts
(s-�'r
Amt.of Deposit$ by
(i Cash(Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee $
Amt.Due Town S
Applicant is responsible far contacting date
aR3'y
the Police Dept.and C.B.Y.D.
1 AGREE 70 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.
Date• (��1�
Signed:
D.L.#
Title:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES