HomeMy WebLinkAboutStreet Cut Permits 171 Old Farm Road (2) 1300157 TOWN OF SOUTH WINDS
PERMIT NUMBER O R, C T
STREET CUT PERMIT
DATE: 07/02/2013
GIS ID: 66300171
MUNIS APPLICATION# 201300923 - = FEE: 25.00
"" = EXPIRATION DATE: 07/02/2014
APPLICANP = 70
NAME: BOUTIN&SONS ��� LOCATION
ADDRESS: 121 WINDSORVILLE f I DREG 1�F-0LI�FARM ROAD
BROAD BROOK, CT66E> K!1SMA1 HOW ARD K JR&CAROL A
` 7I7 IIFARM ROAD
PHONE 860-623-2526 -"- -- V INDSOR,CT 06074
WORK DESCRIPTION: rA
APPLICANT AGREES TO FURNISH THEW1F SCUTIR '
I HE TOWN OF SOUTH WINDSOR FOR ANY EMCTI1 O .BAND REQUIRED AND TO REIMBURSE
4FN`SES INrfiRI>JE TfWNQR 11AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TN oPi PL T IS F I WITI A WLL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO W OF �7if-Tew— SR-'--,--- PEA j MANUAL.
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ISSUED BY /
DAT PJCTED ..:;i-
BY
7/2/2013 3:03 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** INSPECTED
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:
CONTRACroR: C., � 1
LOCATION:-
TYPE OF WORK: O'c 1 .
DATE INSP NEEDED.
DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED
WITNESSED El YES ❑ NO
AS-BUILT:
INPUT: C,�- DATE:
S/FORMWOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN. AVENUE
SOUTH[ WINDSOR, CT
FEE $25.00
. k •
Name of Firm Boutin & Sons Cons t . Co. Phone No. 623=2526
Address of Firm 121 Windsorville Road roa rook, Conn
Location of proposed work i-1 t
Describe fully nature of permit requested
Starting date -7 " 9 . 1 -3 Approx.time for completion j O C� rCe(�
Call before you dig no. 0 O g 1 & Traffic Services Control No. 6
Show sketch of proposed work or furnish . Td be r11if d out bly Tow'ii of So. Windsor'
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit by
O Cash(?Check#
Cut size after Perm. Patch
No.Cuts
Final Billing $
Amt. Due Payee $
Amt.Due Town.$
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. by date
1 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.
4 Signed: Date.
Title• e r G %W D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
y .
W�FWDANI _
SONS PAVING COMPANY INC.
BOUTI N & ,
121 Windsorville Road, Broad Brook, Connecticut 06016
Tel. (860) 623-2526 Consumer Protection Reg.#500258
Date of Call: 3/6/13 Scheduled Work Date:
Date of Estimate: -48,/J? Based Date:
Date of Acceptance: / LJ 1,3 Paver' "-`-
Name: HOWARD KINSMAN Gravel
ct dam' c� - Equip
171 OLD FARM ROAD
Address:: Bitum
SOUTH WINDSOR No.of
Tel: PHONE /86/0/91/6-4903 Price:
Perm
OFF GRAHAM ROAD
Directions:
Description: �t
�,. yApppl
3 y
('I,l,SSE: Nt `I I : DUE TOCURIZINT �� LE\'I'll i"I Yi)F I I�TTTI?`A } Il'T PRICES.
CONTRACT PRICES- WILL. BE SUBJECT TO ANY PLANT MATERIAL CHARGES.
9 L
Quote Good for 10 Days. • • ' •
Special Attention: 1/2 Payment Upon Starling, Balance Upon Completion.
Contract " c L} =' Permit C)�
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. i Pres.
CBUD ->- z ���` C ) Date ! ��-