HomeMy WebLinkAboutStreet Cut Permits 72 Riverside Drive (2) 1200076 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 05/17/12
GI S ID: 76200072
MUNIS APPLICATION# 201200609__ - 25- -
-, FEE; 05/17/13
APPLICANT ' = , . LOCATION
NAME: BOUTIN&SONS ADDRESS, 72 RIVERSIDE DRIVE
ADDRESS: 121 WINDSORVILLEOD flWER BRODEiIRR GERALD L&PAULA A
BROAD BROOK, CT P6911 R VE SIDE DRIVE
PHONE 860-623-2526 =.
SOUTH WINDSOR, CT 06074
WORK DESCRIPTION: DRIVEWAY - =
APPLICANT AGREES TO FURNISH THE TgW9F SOUTH Win NDSOR TIDE AMOUl I OF$OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY_E} PENSES INCURRED BY,TH.E TOWN FOR Iv1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THI APPLICANT IS FAMII IAR-WITj_fA16 WILD,ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OI~ OUgi WINDSR,'STREEf CUT PERI T MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
5/17/201211:06AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
T010 OF SOUTH WINDSOR INSPEMON REPORT
P 11T NO: 02 toO-7 6 t?ONTRACinR:
LOCATION•
.TYPE OF WORK: G-t v-eG
:DATE INSP NEEDED� DATE INSP:
INSPECFEU 6Y: -�h-
WORK IN
.- SEPTTC TANK PUMPED,SMASHED,FILLED WITNESSED LQ YES ❑ NO
'AS-BUILT.-
DIM- Y✓L DATE:
W12007 Town of South Windsor INPS MON REPORT07
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
Name of Firm Bottin & Sons Const. Co. Phone No. 623-2526
Address of Firm 121 Windsorville Road Broad. rook, Conn
Location of proposed work •7 2 Pi ryaiS ell 7),-i u8
Describe fully nature of permit requested Re In e-. r-s ,o/cC a T a 1)oivow�u
Starting date .S- q d - Z Approx.time for completion
Call before you dig no. o /2 o o D S7,9' 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
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee S
Amt,Due Town S
Applicant is responsible for contacting
the Police Dept.and C.S.Y.D. by state
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 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: Date:
Title: SI? /if D.L.#
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES
r/-.Yi e.
BOUTIN & SONS PAVING COMPANY 1�
INC.
121 Windsorville Road._Broact_Rrnnlr__c„--
Date of Call:
Tel. (860) 623-2526
Consumer Protection Reg.#500258
- � /
Scheduled Work Date:
Date of Estimate:
'Co
Date of Acceptance:
Name: je lgf- d J'
D L
Address::
Tel: �'� Ci* y v' /S 7s
,��
Job Location: �`-��;�� � �. eye-
Description:
.� 14
; ®
Quote Good for 60 Days.
Special Attention: 1/2 Payment Upon Starting, Balance Upon Copletion.
_ Contract Permit J15'
A T4
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS.
CBUD /� DU O S� Pres.