HomeMy WebLinkAboutStreet Cut Permits 52 Hearthstone Drive (2) 1300205 TOWN OF SOUTH
PERMIT NUMBER W I N D S O R, C T
STREET CUT PERMIT
DATE: 08/07/2013
GIS ID: 41100052
MUNIS APPLICATION# 201301120 `` FEE:
%
25.00
EIRATION DATE:
- 08/07/2014
APPLICANT1
NAME: BOUTIN&SONSit
LOCATION
ADDRESS: 121 WINDSORVILLEi( � � �RES � SIIIEAITHST ENO DRIVE
" -I�1M�ItVAR DEEPAK M&PURNIMA
BROAD BROOK, CT6(1 !/ -
ARd'HSTONE DRIV
PHONE � sov
VCINDSOR, CT 06074
860-623-2526
l
WORK DESCRIPTION:
DRIVWY
APPLICANT AGREES TO FURNISH THE T / '-
W�FOUTH,, A/MOk�'O BCVD REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN1 �
CONNECTION WITH THIS PERMIT AND THI AP1'L � S
���� �� �,R_ AINTENANCE OR REPAIR WORK IN
F1 2 W" AWI ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFITWI1aI> '
®� 3 C�Pf IMIT MANUAL.
ISSUED BY V� ��
DATE— , "CTED INSPECTED BY
8/7/2013 8:10 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMITNO.: 300 �'� CONTRACTOR: u .l
LOCATION:: J-�f'� '}�5bNe. TV% kke
TYPE OF WORK: �P cc
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS: S
S " *�
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT.
INPUT:_ _ DATE: �' t
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
SDAY 2PM
O TIN & SONS PAVING COMPANY INC.
121 Wndsorvilie Road, Broad Brook, Connecticut 06016
Tel. (860) 623-2526 Consumer Protection Reg.#500258
Date of Cali: 07/08/I3 Scheduled Work Date: ''7 �,d/< y 4/1 de 74
Date of Estimate:
Date of Acceptance: '� 2 - 1 t3
Name: PURNIMA IHAVAR —
E
52 HEARTHSTONE DRIVE `
Address:: —
SOUTH WINDSOR E _
Tel: PHONE 8 Q-6A I272 v —
E
Job Location: OFF MILLERROAD
Description:
� y
f
PLEASE NOTE: DUE TO CURRENT'VOLATILITY OF LIQUID ASPHALT PRICES,
CONTRACT RICES- WILL BE SUBJECT TO ANY PLANT MATEPUAL CHARGES.
Quote Good for Days. " • • ' -. =
F
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract z' z� Permit
ONE YEAR GUARANTEE ON WORKMANSHIP&MATERIALS. Pres.
CBUD C:A'3 1 e53 Date I� (.
C
APPLICATION FOR STREET EXCAVATION PERMIT
Y TOWN OF SOUTH WINDSOR.
PUBLIC- WORKS DEPARTMENT
TOWN MALL
1540 SULLIVAN. AVENUE
SOUTH WI DSOR, CI'
FEE $25.00
Name of Firm Boutin & Sons Const. Co' Phone No. 7!7
Address of Firm 121 Windsorvi e Roa roa �roolc, Conn
Location of proposed work
D cribe fully nature of pe mit requested
Starting date f Approx.time for completion d
Call before you dig no. too
Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town Of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit by
() Cash(1 Check#
Cut size after Perm. Patch
No.Cuss
Final Billing 0
Amt. Due Payee S
Amt.Due Town S
Applicant is responsible for contacting
the Po!ice 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 W,NDSOR 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.
f k— Date: L
Signed:
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES