HomeMy WebLinkAbout10 Beelzebub Road 1100046 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/16/11
GIS ID: 09000010 FEE: 25.00
MUNIS APPLICATION# 201100448 - = EXPIRATION DATE: 05/15/12
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APPLICANT_ -- LOCATION
NAME: BOUTIN&SONS - ADDRESS: 10 I3EELZEBUB ROAD
ADDRESS: 121 WINDSORVILLE4tOAD - 1ER. $OTTI� LLO LORRAINE M
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BROAD BROOK, CT,06fl16 BEELZEBUB ROAD
SOUTH�?ETINDSOR,CT 06074
PHONE 860-623-2526
WORK DESCRIPTION: DRIVEWAY ;
APPLICANT AGREES TO FURNISH THE TOWN OP SOUTH WIN�SOR fi1�E AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPNSE INCUIREID BY"THE TOWN FOR-MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE Af PI ICANT IS FAMILIAR WITH ACID WHL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTII WIND/SR' "STREU I SIT PERMIT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
5/16/201111:I1AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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
MOTS
Location of proposed work 10 Beelzebub Road
Describe fully nature of permit requested Strip e x i s t i n Q d r i v ai ny, r1 r a 4 S With—pr Ac Q S S
gravel, grade, roll and =avP.
Starting date H 16�jj I Approx.time for completion 7/6/11
Call before you dig no. 20112002274 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town of So. wind!
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
U&f e e' S e e SJ/'J e, ��'�/ Amt.of Deposit S by
(}Cash(}C heck#
Cut size after Perm. Patch
No.Cuts
Final Billing $ '
Amt. Due Payee S
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 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 —Lit Date:
Title: �_ 1 j/C /�� ✓ D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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