HomeMy WebLinkAboutdriveway Street Cut Permit 6 Jared Court 1000111 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 07/02/10
GIS ID:46600006
MUNIS APPLICATION# 201000822 FEE: 25.00
EXPIRATION DATE: 07/02/11
APPLICANT LOCATION
NAME: BOUTIN&SONS ADDRESS:` 6 JAREIj COURT
ADDRESS: 121 WINDSORVILLE ROAD OWNER: LIEBMAN HOW ARD S&
BROAD BROOK,CT 06016 6:JARED COURT
PHONE 860-623-2526 SOUTH WINDSOR,CT 06074
WORK DESCRIPTION: DRIVEWAY
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH;WINDSOR TIME AMOUI�JT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURMJJ BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPI ICANT"IS TAM WITH AND WII L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOU*..WINDSR'S=STREEfi CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
7/2/201010:05AM ' PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1000 II l CONTRACTOR: 60Q�LM
LOCATION: coJ c
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: 3 3 1 c
INSPECTED BY: RN:�
WORK IN
PROGRESS: 'i1 �--� Lam,V
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:_ DATE: 1
W12007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT /1/
TOWN OF SOUTH WINDSOR
PUBLIC• WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623-2526
Address of Firm 121 Windsorvi e Roadroa rook, Conn
06016
Location of proposed work h jgrpri r,,,,
Describe fully nature of permit requested 4 1-r;r, . eYi g t ing Elr-ik-eway, add gravei ES
needed, grade, roll nnri paVA
Starting date Approx.time for completion
Call before you dig no. 2 n 1 0 2 7 n o 9 H 5 Traffic Services Control No.
Show sketch of proposed work or furnish TO Ile filled Out by Town of So. windsoI'
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
yA � No.cuts
e—
Amt.of Deposit S by
f O Cash O Check#
r
Cut size after Perm. Patch
a
No.Cuts
S > Final Billing$
Amt.Due Payee $
Amt.Due Town .$
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. by state
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.
6/29/10
Signed:
Date
Title: Secretary D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES