HomeMy WebLinkAboutStreet Cut Permits 66 Windshire Drive (2) 1000199 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/21/10 `= "
GIS ID: 95100066 = - FEE: 25.00
MUNIS APPLICATION# 201001266 , " EXPIRATION DATE: 09/21/11
APPLICANT LOCATION
NAME: BOUTIN&SONS -ADDRESS: 66 WINI)SHIRE DRIVE
ADDRESS: 121 WINDSORVILLE ROAD OW fiER; ,G- - i`�IN JUDITH E
BROAD BROOK,CT 0601'6 - 4"WINDSHIRE DRIVE
' SOUTH WINDSOR,CT 06074
PHONE 860-623-2526 - =
WORK DESCRIPTION: DRIVEWAY,-
APPLICANT AGREES TO FURNISH THE TOWN OFSOUTH WIN6§0k'-IE AMOUNT OF-B-OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANYEXPfiISLS INCURIEI?B ',THE TOWN IjORIV1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS I-01 jAR WltT AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WiNDSR'S.STREET CUT'PIyRIvIIT MANUAL.
ISSUED BY ATE INSPECTED INSPECTED BY
9/21/201011:20AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
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PERMITNO.: / CONTRACTOR:
LOCATION: 6(o ? I✓I�,15 A I
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:_ 'W _ 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 Cons t. Co . Phone No. 623-2526
Address of Firm 121 Windsorville Road roa rook, Conn
Location of proposed work 66 Windshire Drive
Describe fully nature of permit requested Strip existing_driveway.aprons, dress with process
rgravel, grade roll and pave.
Starting date Approx.time for completion
Call before you dig no. 20103702406 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 Prop.size of cut
No.cuts
Amt.of Deposit S by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
41 - Final Billing S
S X 1 .Z Amt.Due Payee S
Amt.Due Town S
Applicant is responsible for contacting
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:
i
Title:— 6 D.L.#
_ 01
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES