HomeMy WebLinkAboutStreet Cut Permits 254 Sand Hill Road (2) 1300103
PERMIT NUMBER TOWN OF SOUTH W I N D S O R CT
STREET DATE: 05/16/2013 --- CUT PERMIT
xv-
GIS ID: 79800254 dd--- /
MUNIS APPLICATION# 201300656 %!��
FEE: 25.00
PIR
,�
ATION DATE:
APPLICAN = %/� = 05i16i20 14
NAME:
BOUTIN&SONS
LOCATION
ADDRESS: 121 WINDSORVILLEf _ /� DDRE
BROAD BROOK, CT E4 SA1ID HILL ROAD
6 - my -— i)GQI&FEOMA
PHONE ' ME
� 9- NbHILL ROAD
860-623-2526 '
H *INDSOR, CT 06074
WORK DESCRIP
TION: DRIVE
APPLICANT AGREES TO FURNISH THE
THE TOWN OF SOUTH WINDSOR FOR AN i
CONNECTION WITH THIS PERMIT AND THISE9 OB ND REQUIRED AND TO REIMBURSE
FOR PERMITS AS OUTLINED IN THE TOWN p�9 � - � CIOI� AINTENANCE OR REPAIR WORK IN
1I I A WL ABIDE BY THE RULES AND REGULATIONS
C m r+ - � IT MANUAL.
IL
ISSUED BY '/ I
DATE
5i16i20I3 I I:43 AM CTED INSPECTED BY �-*** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
----------------
-----------
-----------
-_
Alm
i
","
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1,300103 C0NTRACT0R: ,6ou;6 iv
LOCATION: 42.n,/ A II
TYPE OF WORK: e -
DATE INSP NEEDED: DATE INSP: l - ( "jj`
INSPECTED BY:
WORK IN
- PROGRESS: - -
u3
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT.
INPUT: DATE.
S/FORMS/TOWN OF SOUM 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
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 �L�Li
Describe fully nature of permit requested r'�JC
V
Starting date Approx.time for completion
Call before you dig no. L4 11 15'<�� 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 S by
O Cash(1 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.B.Y.D. by date
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REOUIRED 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
7■��/A��y7 ■/��p/�® T HOUSE
T T NEXT
i®� DOOR
TVIOA1. A 10:30 ! O 1 Q HOUSE RIGHT NE.2 A. DOOR
4 BOUTIN & SONS PAVING COMPANY, INC.
121 Windsorville Road, Broad Brook, Connecticut 06016
Tel. (860) 623-2526 Consumer Protection Reg.#500258
04/17/13
Date of Call: Scheduled Work Date:
04/22/13
Date of Estimate: Based Date:
Date of Acceptance: - ' Paved Date:
Name: PETER-D'AMATO- Grav
Equii
Address::
SAND HILL ROAD Bitur
SOUTH WINDSOR No.
Tel: PHONE 860-916-7706 PricE
J Pern
'J 4
Directio@fF
Description:
t 'y
: .. .y.
t
1 ,
1 fop/
1 i
I
Quote Good for 60 Days. 1 fj
e s •• -s
Special Attention: 4/2 Payment Upon Start! g, Balance Upon Completion.
Contract r ` = r Permit
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pres.
CBUD iv �� 5�0 Date o0�