HomeMy WebLinkAboutStreet Cut Permits 114 Rockledge Drive (2) 1100051 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/02/11
GIS ID: 76800114 FEE: 25.00
MUNIS APPLICATION# 201100524 EXPIRATION DATE: 06/01/12
APPLICANT ` , -=--- ; LOCATION
NAME: BOUTIN&SONS ADDRESS; 114"IZOCKLEDGE DRIVE
ADDRESS: 121 WINDSORVILLE ROAD" ," iol) R: IVIARSHALL MICHAEL L&TRACY L
BROAD BROOK,CT 06Q16 114 ROCKLEDGE DRIVE
fliJ1 WINDSOR,CT 06074
PHONE 860-623-2526
WORK DESCRIPTION: DRIVEWsY =
APPLICANT AGREES TO FURNISH THE tOW--�-6O SOUTIII WINDSOR CIE AMOUNT OF BAND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AIVY EXPENSES INCURREDY TIDE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FA MILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SQUTH WINI3SR'S STREET CUTPERMIT MANUAL.
I1 1-1� i11 i e�
ISSUED BY DATE INSPECTED INSPECTED BY
6/2/201110:26AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /100S I CONTRACTOR: &u A)
LOCATION: I I Ie",16 e I)c V-e
TYPE OF WORK: l tva
DATE INSP NEEDED: DATE INSP: 3/ /z
INSPECTED BY:
WORK IN
PROGRESS: +6 5 K A
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 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 060115
Location of proposed work 114 Rockledge Drive
Describe fully nature of permit requested strip. existing driveway, add gravel ns
needed, grade, roll and pave.
Starting date Approx.time for completion
Call before you dig no. 20112100973 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
Final Billing S
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 W1NDSOR 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.
�/If" G C c� L"� L�Gl�
Signed: � y � Date:
Title:- D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
-00
ANYTIME 0.
BOUTIN & SONS PAVING COMPANY, INC.
121 Windsorville Road, Broad Brook, Connecticut 06016
Tel. (860) 623-2526 Consumer Protection Reg.##500259
Date of Call: 05/02/11 Scheduled Work Date:
Date of Estimate: f Completion Date: _ _—
Date of Acceptance:
Name: MIKE MARSHALL
114 ROC;KLEDGE DRIVE
Address::
SOUTH WI1\IDSOR '
Tel: PHONE 860-273-73#5 WORK
OFF NEVERS ROAD
Job Location:
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Description: '' "� '� i��• ) '��t
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URRENT VOLATIL11 Y OF LIQUIlD ASPHALT PRICES,
i r i,1t A _ BE SUBJECT TO ANY PLANT MATERIAL CTJARG.I=S.
Quote Good for W Days.
A._
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract ` -� � Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pres
CBUD 1 �1J 1- ' Date •�