HomeMy WebLinkAboutStreet Cut Permits 35 Jonathan Lane 1100059 TOWN OF SOUTH WINDSOR C
PERMIT NUMBER T
STREET CUT PERMIT
DATE: 06/21/11
GIS ID:47800035
MUNIS APPLICATION# 201100629 FEE: 25.00
EX'IRATION DATE: 06/20/12
APPLICANT LOCATION
NAME: BOUTIN&SONS ADDRESS: 35 JONATHAN LANE
ADDRESS: 121 WINDSORVILLE It�tI? OWNER: GALLEY-BRYAN&HELENA
BROAD BROOK, CT 06Q1=b
" 35 JONATHAN LANE
PHONE 860-623-2526 SOUTH -INDSOR,CT 06074
WORK DESCRIPTION: DRIVEt ,Y
APPLICANT AGREES TO FURNISH THE TOWN OF"SOUTH WINDSOR T1E AMOUI*N OF BIND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY=XXPENSES WCURREIS.BY TIDE TOWN FOR]MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLfGANT IS FAMILIAR WITH AN33 WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'STREIrT'CUTpERN1IT MANUAL.
I'
ISSUED BY DATE INSPECTED
INSPECTED BY
6/21/201111:13AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: //40D, CONTRACTOR: A)
LOCATION:
TYPE OF WORK: U-e a
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: 1sn
WORK IN
PROGRESS:
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: G`v%— DATE:
W12007 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 Windsorville Road roa rook, Conn 06016
Location of proposed work 35 Jonathan Lane
Describe fully nature of permit requested Strip existing driveway, add gravel, grade,
roll and pave.
Starting date r,497111 Approx.time for completion 7/2 7/11
Call before you dig no. 20112202892 Traffic Services Control No.
;rl,)V ° a` To be fiIIed out by Town of So. Windsor'
Pavement Cut
r ¢� �- Prop.size of cut
o
No.cuts
Amt.of Deposit S by
-76
Cash()Check#
Cut size after Perm. Patch
YO
) 3 ! Ell
,. No.Cuts
Final Billing s
Amt. Due Payee S
f lJ
-i --- Amt.Due Town S
pp by - date
rry r1R T T()T ITT-)UPT-T A T.T` PR ICF,S_� ; �
1 AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND 10 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: :Ui/� Z�7� �ii ✓G� Date: •
Title: ��/ D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES