HomeMy WebLinkAboutStreet Cut Permits 80 Greenwood Drive (2) 1200115 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 06/26/12
GIs ID• 38700080 = FEE: 25 00
MUNIS APPLICATION# 201200845 = EXPIRATION DATE: 06/26/13
APPLICANT = LOCATION
NAME: BOUTIN&SONS ffADDRESS; A GREENWOOD DRIVE
ADDRESS: 121 WINDSORVILLE LZOD = t?�IER AV-OUBAASHA A
BROAD BROOK,CT 06bff 64 IEM1G ST
SOUT WINDSOR,CT 06074
PHONE 860-623 2-526 -= "-
-
WORK DESCRIPTION: DRIVEWAY,
THE DRAIN LAYER ASSIGNED TO THIS PERMITI-1AS A VAJD LIG ISI�ISSUEI) 3Y TIC SfiATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTfl&THE�ATT G B`C NI3YTIONfi AI. WQ1tK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS AI>I C3SHA REQ 1 EMENCS,ANI2THIz ATTACHED CONDITIONS.
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ISSUED BY DATE WSPECTED INSP CTED BY
6/26/2012 12:23 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /� �� SP CONTRACTOR: L2
LOCATION: �o G cne 1 wood
TYPE OF WORK: t'
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: ZZ
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L DATE:
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 WI�tDSOR, CT
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623=2526
Address of Firm 121 Windsorvi e Roadroa rook, Conn
MOM
Location of proposed work 2—�r e- e ., /-1121 c/ 0r141e
Describe fully nature of permit requested -721,5 7-� Tjr,�i��i
Starting date /O—/2 Approx.time for completion (i -/Z r/ 7-
Call before you dig no. A/i R 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 G ass+rL Prop.size of cut
No.cuts
�&Dep�osit
by
i O Cash O Check#
J Cut size after Per tch
No.Cuts
Final Billing S "
Amt. Due Payee S
_ Amt.Due Town S
Applicant is responsible for contacting
the Ponce n6pt. ne l;,B.,Y.n_ 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 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:— D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES