HomeMy WebLinkAboutStreet Cut Permits 87 Garnet Lane (2) 1200179 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 09/18/12
GIS ID: 34800087
MUNIS ARRLICATJON# 2nl')nizi� _ FEE: 25.00
1 DATE: 09/18/13
APPLICANT „ LOCATION
NAME: BOUTIN&SONS ADDI2E&S: 87 GAIWET LANE
ADDRESS: 121 WINDSORVILLE ROAD? ozOWNER ByRKAOHN A
BROAD BROOK, CT 06016 f --AETLANE
OUTH WINDSOR,CT 06074
PHONE 860-623-2526
all
WORK DESCRIPTION: DRIVBVyY
APPLICANT AGREES TO FURNISH THE TOWN(F SOUTH WINDS THE.AMOUNI OF B0 D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPE1*I ES IN I1RI b y IHE T{)y{tN FOR I1&NTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AP'LICANT IS F�MI1fiR UVIT AND WILT ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOIJTI�WINDER STI ERF CUTPERMIT MANUAL.
ISSUED BY ATE IIT PELTED INSPECTED BY
9/18/201212:17PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_M 00 /7
CONTRACTOR: &()q-J
LOCATION: 7 `� yl,PC ! ,
TYPE OF WORK: T)t 1 \I Ct )a (...(
DATE INSP NEEDED: DATE INSP: 3 r3
INSPECTED BY: f3D
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:— DATE: �� t
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
OWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINPSOR, CT
Name of Firm Boutin & Sons Cons t. Co. Phone No. 623-2526
Address of Firm 121 Windsorville Road Broad. nook, Conn 06016
Location of proposed work 87 GaEnet Lanz
Describe fully nature of permit requested remove and replace existing driveway
Starting date 24/12 Approx.time for completion 30 days
Call before you dig no. _2012 360 2689 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$ by
O Cash t)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 • 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: 9/13/12
Title: Secretary D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES