HomeMy WebLinkAboutStreet Cut Permits 675 Clark Street (2) 1100143 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER ,
STREET CUT PERMIT
DATE: 09/22/11
GIS ID:20400675
MUNIS APPLICATION# 201101098 = FEE: 25.00
EXPIRATION DATE: 09/21/12
APPLICANT/ - - LOCATION
NAME: BOUTIN&SONS ` ADDRESS: 6�S CLAIZK STREET
ADDRESS: 121 WINDSORVILLE 0-AD O NER- CW�KLA,RICHARD M&BEVERLY
BROAD BROOK, CT�06 =" 675 'CLARK STREET
PHONE 860-623-2526 SOUTH WINDSOR,CT 06074
WORK DESCRIPTION: DRIVEW ,Y - -
APPLICANT AGREES TO FURNISH THE I#JW OF SOiJT11)R-_ M&W THE AMOUI*tT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANiEM�1'ENSES II+ICURI D$_'THE TOWN T OR kAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THT A6LICANT IS FA—m--- =dAR WITH AN WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOiJfiH WINDSR'—STRtET-CUI P$RHIT MANUAL.
ISSUED BY
DATE INSPECTED
INSPECTED BY
9/22/201111:09AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: _/ D®J V,3 CONTRACTOR: i a✓r)
LOCATION:_G1 75
TYPE OF WORK: ►fir
DATE INSP NEEDED: DATE INSP: LZ
INSPECTED BY: B
WORK IN 1
PROGRESS:_ --c /V cv >; k
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: Vltl— DATE:_ f
W/2007 Town of South Windsor INPSECTION REPORT 07
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 Windsorvi e Roa roa rook, Conn 06016
Location of proposed work 675 Clark Street
Describe fully nature of permit requested Strip. existing driveway, dress with process
gravel, grade, roll and pave.
Starting date 9/2 h/11 Approx.time for completion 10 2 6.111
Call before you dig no. 20113801456 Traffic Services Control No.
Show sketch of proposed ork or furnish. To be filled out by Town of So. Windsor
two copies of separate dr Pavement Cut
Indicate North Prop.size of cut
l V No.cuts
v Amt.of Deposit S by
Cash t 1 Check#
I ` Cut size after Perm. Patch
/ No.Cuts
_ f •
Final Billing S "
Amt. Due Payee S
/y
Amt.Due Town S
Applicant is responsible for cc tacting
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 1 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:- (/��i✓t�Gt�C �.. %yw�L-- Date. 9/14/11 .
Title: Secretary D.L.# ~
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES