HomeMy WebLinkAboutStreet Cut Permits 691 Governors highway (2) 1200045 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/16/12
GIS ID: 36900691 FEE: 25.00
MUNIS APPLICATION-# 2012QQ414 r—VD_ru AMMXT_nA Tom. AA-11_L]t_'1
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APPLICANTIFF LOCATION
NAME: BOUTIN&SONS RESI- A-f GOVERNORS HIGHWAY
ADDRESS: 121 WINDSORVILLE R01D %f yV ER > TORKIN6TON DAVID N&NANCY S
BROAD BROOK, CT(6I?L6 = 6l GOVERNORS HIGHWAY
R TH WINDSOR,CT 06074
PHONE 860-6231-526 -
WORK DESCRIPTION: DRIVEWAY%ik
THE DRAIN LAYER ASSIGNED TO THIS ISERMIT BIAS A V---AIjI LLI TSSUED �'TH1 STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT INfiI I ATT�CfIIli? I�I�s INN I N FALL WiO tK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS1LI OSHA Rt�VIEIGIENTS ANC THE ATTACHED CONDITIONS.
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ISSUED BY DATE INSPECTED INSPECTED BY
4/16/2012 2:35 PM
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TOWN OF SOUTH WINDSOR,INSPECTION REPORT
PERMIT No.- • l a0D®y3 CONTRACTOR:
LOCATION:
'TYPE OF
•DATE INSP NEEDED; DATE INSP: _
INSPECT-FD
WORK IN
PROGRESS:,SEPRC TANK PUMPED;Q
D WITNESSED El YES El NO
AS-BUILT:
INPUT.- DATE:
W12007 Town of South Windsor INPSEMON REPORT 07
APPLICATION FOR STREET
XCAVATION PERMIT
O N OF SO WINDSOR
PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN.AVENUE
SOUTH WjNDSOR, CT
Name of Firm Boutin & Sons Cons t . Co. Phone No. 623--2526
Address of Firm 121 Windsorville Road roa rook, Conn
06016
Location of proposed work �o C/ ®r/e -17 6 h Al is
Describe fully nature of permit requested /f e /Yl.h d z .n 61 g 4-9/A C e- �/i_t Tin eo n r/yC W g U .
Starting date y' Z 3 '/ Z Approx.time for completion - Z 3 -/ 2-
Call before you dig no. O 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$ by
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
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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 T' E A
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
CSigned:. Date: Z/
Title• �e D.L.# `
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Friday 3: 45
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BOUTIN & SONS PAVING COMPANY, INC.
121 Windsorville Road, Broad Brook, Connecticut 06016
Tel. (860) 623-2526 Consumer Protection Reg.#500258
Date of Call: 3 .29 12_ Scheduled Work Date:
Date of Estimate: 3/30/12 Completion Date:
Date of Acceptance:
Dave Turkington
Name: Gravel:
Equipment:_
Address:: 691 Governors Highway
South Windsor Bituminous
Tel: 841-3779 No.ofs Vt:
Pricer
+ 25.(
Job Location: li-�V' /Z >- —
Description:
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Special Attention: 1/2 Payment Upon Starting, Balance Upon C pletion.
Contract S' Permit
ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS. Pres.
CBUD C% 2, '4 6 - Date �-