HomeMy WebLinkAboutStreet Cut Permits 178 Quarry Brook Driv (2) 1100167 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/17/11 -
GIS ID: 74100178 - - FEE: 25.00
MUNIS APPLICATION# 201101214 EXPIRATION DATE: 10/16/12
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APPLICANT - LOCATION
NAME: BOUTIN&SONS ADDRESS: Q8 QUARRY BROOK DRIVE
ADDRESS: 121 WINDSORVILLE ROAD. OWNER: „IFANDGTEBE JAMES &
BROAD BROOK,CT.060I"b 17$ QUARRY BROOK DR
S�Ui WINDSOR,CT 06074
PHONE 860-623-2526 = =
WORK DESCRIPTION: DRIVEWAY -
APPLICANT AGREES TO FURNISH THE TflWItiT�F SQUTH WIND80R TIDE AMOUNT OR-BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY.E PENSES,INGCUED$Y THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI APILCANT IS FAIvIiLIAR WITH AND-WI€l ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OhO6 IfWINDSR S STREET CUT PERMIT MANUAL.
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ISSUED BY DATE IlVSPEC ED INSPECTED BY
10/17/2011 11:01 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: - I 00 r7 CONTRACTOR: got / h1
LOCATION: 1 7
.'TYPE OF WORK:_
DATE INSP NEEDED: DATE INSP: z�
INSPECTED BY:_ �
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC• WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Const. Co. Phone No. 623-2526
Address of Firm 121 Windsorvi e Roadroa rook, Conn
Location of proposed work 178 QtinrrW Brank Dri l7e
Describe fully nature of permit requested Strip PxictinrjriVeWay�,drp.gg 40.1i1;14
process gravel, grade, rall and Lave_
Starting date �21t/11 - -_Approx.time for completion 1
Call before you dig no. 2 01 1 41 0 31 9 6 Traffic Services Control No.
q
Show sketch of proposed work or furnish TO be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North /I Prop.size of cut
f
No.cuts
Z f Amt.of Deposit S by
Cash O Check#
. 55
Cut size after Perm. Patch
✓`�� _ No.Cuts
Final Billing S '
Amt. Due Payee S
Amt.Due Town .$
Applicant is responsb for contacting
the Police Dept.and C.B.Y.D. bye.•,_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. 10 7 11
Title: t i- D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES