HomeMy WebLinkAboutStreet Cut Permits 75 Riverside Drive (2) 1200075 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/17/12
GIS ID: 76200075 FEE: 25.00
- MUNIS_APPLICATION#__2012n0Fns 17%13 --
APPLICANT LOCATION
NAME: BOUTIN&SONSAF 75 RIVERSIDE DRIVE
ADDRESS: 121 WINDSORVILLE R�}AD - OWJEI W-EIGEA EDWARD
BROAD BROOK, CT 0606 = = 7`S.RIVERSIDE DRIVE
01JTfI WINDSOR, CT 06074
PHONE 860-623-2526
WORK DESCRIPTION: DRIVEWAY
APPLICANT AGREES TO FURNISH THE PWTpOF SOUTH, EAMQUI13 t1T,BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPEN1 S 5 INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI APk4lCANT IS F" IILIAR WITk7AND WII I ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOL3fiH WINDSR'S STREET.CUT IsERIiIIT MANUAL.
ISSUED BY DATE INSPEe TED INSPECTE Y
5/17/201211:02AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
_ • PERMIT NO.: •1 bba.7 OpN TRACflOR: -
LOCATION:
'TYPE OF WO
:DATE INSP NEED®: DATE INSP: /-
INSP 6Ya Csi�—
WORK IN
PROGRESS:
SEPTIC TANK PUMPED,SMASHED, FILLED WrMWED (]YES Q NO
AS-BUILT.-
DATE...
W12007 Town of South Windsor INpSEcuoN REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR CT
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623-2526
Address of Firm 121 Windsorvi e Roadroa rook, Conn
Location of proposed work 7 S /G' r'//e�,S P✓///e
Describe fully nature of permit requested 4 e ✓YI e e/ 4e /,c Ce- X/.5 7,e7 lei/yt e-.�a �Ir_
Starting date S- Z Approx.time for completion & -y s'12-
Call before you dig no. 6 /�/ O 2 1Traffic Services Control No.
-Show sketch of proposed work or furnish TO be gilled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
e-
No.cuts
j Amt.of Deposit S by
O Cash O Check#
��// Cut size after Perm. Patch
/ z
No.Cuts
' Final Billing S '
Amt.Due Payee S
Amt.Due Town S
Applicant is responsi le 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: .J C r �'� D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES