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HomeMy WebLinkAboutStreet Cut Permits 25 Valley View Drive (2) 1100025 PENT NUMBER TOWN OF SOUTH W I N D S O R, CT DATE: 04/12/11 STREET CUT PERMIT - ` GIS ID:91200025 MUNIS APPLICATION# 201100281 FEE: 25.00 -EXPIRATION DATE: APPLICAN I` - o4n l n 2 NAME: BOUT IN&SONS = LOCATION ADDRESS: 121 WINDSORVILLE ROAD ADDRESS 2�GALLEY VIEW DRIVE BROAD BROOK, CT Q6Q16 - ©WhTER: MELOUGH DAMES STEWART&NANCY S PHONE ;CAI I EY VIEW DR 860-623-2526 DUTH WINDSOR,CT 06074 WORK DESCRIPTION: DRIVE - -- APPLICANT AGREES TO FURNISH THE VOWS pFEOUTH THE TOWN OF SOUTH WINDSOR FOR ANY W1NDSOR THl AMOUIatTREQUIRED CONNECTION WITH THIS PERMIT AND THE APPL-1ANI FAMILIAR WITH AND WALL ABIDE By T AND TO REIMBURSE FOR PERMITS AS OUTLINED IN THE TOWN OF SQLTCA WINDSR'S �E TOWN FQR Iv1AINTENANCE OR REPAIR WORK IN HE RULES AND REGULATIONS CUT PERMIT MANUAL. ISSUED cz - - DATE 4/12/20119:00AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** INSPECTED BY ---------- ------------ TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: />d®oo?,S CONTRACTOR: &xoLjA,) LOCATION:_ 2 VA 1lf�j VjVW Dr'ov P J TYPE OF WORK: 6, DATE INSP NEEDED: DATE INSP: a ,2. 12- INSPECTED BY: WORK IN PROGRESS: SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: C DATE: W/2007 Town of South Windsor INPSEMON REPORT 07 APPLICATION FORSTREET EXCAVATION PERMIT N OF SOUTH WINDSOR PUBLIC' WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN.AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm Boutin & Sons Const. Co. Phone No. 623-2526 Address of Firm 121 Windsorville Road roa rook, Conn 06016 Location of proposed work Q LS ( } Cjk �aj V Describe fully nature of permit requested C i, Starting date 1 Approx.time for completion Call before you dig no. ` 0 I t 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(}Check# Cut size after Perm. Patch No.Cuts Final Billing S ' Amt. Due Payee S �Q f •. Amt.Due Town S Applicant is responsible for contacting the Police Dept.and C.B.Y.D. by date 1 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: 6 Date: Title: D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES