HomeMy WebLinkAboutStreet Cut Permits 10 Beelzebub Road 1100046 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/16/11
GIS ID: 09000010AL
FEE: 25.00
MUNIS APPLICATION# 201100448 EXPIRATION DATE: 05/15/12
APPLICANT " "--—`= LOCATION
NAME: BOUTIN&SONS = ADDRE� 10 BEELZEBUB ROAD
ADDRESS: 121 WINDSORVILLE ROAD = QWI�I 3 BOTTLC LLO LORRAINE M
BROAD BROOK,CT 06a4 6 10 BEEIIEBUB ROAD
OUFI VPINDSOR, CT 06074
PHONE 860-623-2526 =
WORK DESCRIPTION: DRIVEWAY ;
APPLICANT AGREES TO FURNISH THE TpWN OF SQUTH= SOR T"E"AMOUNT OR-A ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AM-EXPENSES INCURRED-BY THE TO�1 FQR-MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE ARPI LC ANTI FAMILIAR I?YIfiH A11 WPL L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF9i7TI WINI�SR�:`STREET QUT=PERMIT MANUAL.
r
ISSUED BY DATE INSPECTED INSPECTED BY
5/16/2011 11:11 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 I too y to CONTRACTOR: 2b
LOCATION: 10 wee 1 zebu b
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: 1 it z f ll
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C. DATE:
W/2007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC• WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623-2526
06016
Address of Firm 121 Windsorville Road Broad. rook, Conn
Location of proposed work 10 Beelzebub Road
Describe fully nature of permit requested Strip .existing r�l r i vp w�z_d r e G S W i f b l i 9 a Q 2 S
gravel, grade, roll and =ave.
Starting date6•�(�/�_� Approx.time for completion 7/6/11
Call before you dig no. 20112002274 Traffic Services Control No.
Show sketch of proposed work or furnish To be ftIled out by Town of So. Wind;
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
�� 2✓ .5 �, S/'l, �C'!ri Amt.of Deposit S by
1, le— . O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing$
Amt.Due Payee $
Amt.Due Town .$
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 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: /��t�;_/ C���"G Date:
Title: '/ e� D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
d
O
(30�