HomeMy WebLinkAboutStreet Cut Permits 86 Juniper Lane (2) 1200144 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 08/20/12
GIS ID:49200086 FEE: 25.00
MI TWO, APP-T TCATT(INTif_7AI M1htiZ _
APPLICANT ,, - ;,LOCATION
NAME: BOUTIN&SONS
RE 86 IYINIPER LANE
ADDRESS: 121 WINDSORVILLEOD f = I % � R� MCRRISIICHELLE L
BROAD BROOK, CT 060j JJNIPI✓R LANE
,SC?L3T WINDSOR,CT 06074
PHONE 860-623-2526
WORK DESCRIPTION: DRIVEWAY
APPLICANT AGREES TO FURNISH THE TO WLjQF-SOUTH� DSUR T�AMOUNT O�$OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC-E P SE IN I3I THE TOWN FOR IYfAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLI. ANTJS FA�IILIAIMITI-I-AN- WIL-ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN
O��F SOUTI WIDSR STRI P I CUT PIRNIT MANUAL.
ISSUED BY DAMN PVCTED INSPECTED BY
8/20/2012 10:33 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ! CONTRACTOR:__� C -]
LOCATION: Df 12Lactne-
TYPE OF WORK: lk ae&jaz�
DATE INSP NEEDED: DATE INSP: 1-/4 13
INSPECTED BY:
WORK IN
PROGRESS:,_;
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: �(�-�-- DATE: k / 7°
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WItDSOR, CT
J
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
Describe fully nature of permit requested Lta, !✓ Iy (7!y v-sT ;:�v/ /ve GJ D,-/&'le 4j 4
Starting date 8 -3D -/Z Approx.time for completion 9-/S '/ 2-
Call before you dig no. a 6 J eZ 3 26 / 7S- 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
Amt.of Deposit S by
Cash O Check# -
Cut size after Perm. Patch
No.Cuts
Final Billing S '
Amt.Due Payee S
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: Date:
Title: S e c r� /�/ D.L.# `
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
,MONDA.Y ANYTIME AT7-c!
BOUTIN -tL , INC.
12' JILCALVIIN M. BLACKWELL, SR.
PRESIDENT Consumer Protection Reg.#500258
Date of Call:
07/30/12 M OP CO NATEO
105 HIGH RACK ROAD SANDY HOOK CT 06482
Date of Estimate:
Date of Acceptance:
Name: MICHELLE MORRIS -A2A
r 4s
r
86 JUNIPER LANE ;p
Address::
SOUTH WINDSOR
Tel; PHONE 860-644-6923
203-258-4045
Directions: OFF ELLIN.GTON RD, FAIRVIEW DR, TUMBLEBROOK,SAWMILL LN
Description: �6
i
. 6
LA ON)
PLEASE NOTE: DliE TO CI-JRRENT VOLATILITY OF LIQUID ASPHALT PRICES,
CONTRACT PRICES- WILL, BE SI3BJECT TO ANY PLANT MATERIAL CHARGES.
Quote Good for Days.
Special Attention:1/ Payment Upon Starting, Balance Upon Completion.
Contract
.- Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pres.
CBUD Z, 3 -3c, �� Date G' ' X-/ Z