HomeMy WebLinkAboutStreet Cut Permits 185 Natsisky Farm Roa (2) 1100106 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 07/29/11 ,= -
GIS ID: 62300185 _ FEE: 25.00
MUNIS APPLICATION# 201100843 - E £PIRATION DATE: 07/28/12
APPLICANT - LOCATION
NAME: BOUTIN&SONS - AI3DRES 185 NATSISKY FARM ROAD
ADDRESS: 121 WINDSORVILLEROAD OIOJ RECHARD R&JOYCE D
BROAD BROOK, CT;060I=6 1$5 NATSISKY FARM RO
SOUTH WINDSOR,CT 06074
PHONE 860-623-2526
WORK DESCRIPTION:
APPLICANT AGREES TO FURNISH THE TOWN OFsOUTH [BINDS wm
E AMOUNT OF B D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANi 5XiENSES INCURREII BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE 4d-CZI T IS FAMILIAR WITH AND-WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'S STREETEUT PPR-MIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
7/29/201111:00AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ( 00M CONTRACTOR: 6el, VIA,)
LOCATION: raO_01
P
TYPE OF WORK: 40 U--e coo 64
DATE INSP NEEDED: DATE INSP: /p
/,a7 k
INSPECTED BY: Ab
WORK IN
PROGRESS: L ov ccnj
Q k—k- C ra- l
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES [-] NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
OWN OF SOH 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
Location of proposed work 185 Na t-s i s kv Farm Rd
Describe fully nature of permit requested Strip .apron, grade, roll and =avP.
Starting date 8 1 11 Approx.time for completion 1
Call before you dig no. 20113003768 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 art
No.cuts
Amt.of Deposit S by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing $
Amt. Due Payee $
x Z d C r Amt.Due Town .$
Applicant is response a 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:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES