HomeMy WebLinkAboutStreet Cut Permits 102 Hillside Drive (2) 1300086 TOWN OF SOUTH WIND
PERMIT NUMBER S O R, C T
STREET CUT PERMIT
DATE: 05/09/2013
GIS ID:43800102
MUNIS APPLICATION# 201300580 JX FEE:
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EXPIRATION DATE: 25.00
05/09/2014
APPLICANT/
NAME: BOUTIN&SONS j LOCATION
ADDRESS: 121 WINDSORVILLE. AIi/� DRE5 f2 HILL SIDE DRIVE i�
BROAD BROOK CT� 6 % Eft TRACEI ROY
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- 0 Itts DRIVE
PHONE j INDSOR
860-623-2526 r; � � � , CT 06074
WORK DESCRIPTION: DRIEY ��
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APPLICANT AGREES TO FURNISH THE TION F SpUTHff
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THE TOWN OF SOUTH WINDSOR FOR ANC pN � E1MOF fEBND REQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THI✓A&44CAw is � OR AINTENANCE OR REPAIR WORK IN
FOR PERMITS AS OUTLINED IN THE TOWN OIbl1fiV,IIjDs T MAN
ID
EAL.
BY THE RULES AND REGULATIONS
ISSUED BY DASV Vj CTED
INSPECTED BY
5/9/2013 2:28 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO. CONTRACTOR:
0
LOCATION: (� , r.
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TYPE OF WORK:
DATE INSP NEEDED:
DATE INSP: t A %31
INSPECTED BY: (S
WORK IN
PROGRESS: ��
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:_G yam- 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 WINDSOR, CT
FEE $25.00
Name of Firm Boutin & Sons Cons t . Co. Phone No. 623-2526
Address of Firm 121 Windsorvi e Road roa rook, Conn
Location of proposed work iL J( t 1� iC'tQ -)if'\,\, Z
Describe fully nature of permit requested ��Q..s"�tf.J�� {�..tf'�.c'� �� 3�{^;:� ,� ( ,Got e I I •�7�
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Starting date � Approx.time for completion
Call before you dig no.��jj_3 120 a %E — Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town Of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
Q) Cash (}Check#
Cut size after Perm. Fetch
No.Cuts
Final Billing 8
Amt. Due Payee S
Amt.Due Town S
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 I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOU T'x i WINDSOR'S STP,:_ET CL17 PERMIT"MANUAL.
Signed:
Dates `�, 1 1
Tide: :> c'C,!'e 7R /ems D.L.#
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES
, ESDAY 9:00
BOUTIN & SONS PAVING COMPANY, INC.
121 Windsorville Road, Broad Brook, Connecticut 06016
Tel. (860) 623-2526 Consumer Protection Reg.#500258
04/22/13
Date of Call: Scheduled Work Date:
04/23/13
Date of Estimate: Based Date:
°
Date of Acceptance: Paved Date:
Name: ROY TRACESKI Gray.
Equii
102 HILLSIDE DRIVE
Address:: Bitun
SOUTH WINDSOR No.c
Tel: PHONE 860-644-9341 --Prime
Perm
Directio(W.F
Description:
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PLEASE NOTE: DUE T CURREV34VOLATiCay OF, LIQUID ASPHALT PRICES, °
CONTRACT PRICES- WILL BE SUBJECT TO ANY PLANT MATERIAL CHARGES. t'[�:,�`� rv/ff" °
Quote Good for 10 Days. U.30
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Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract / ` Permit ,. %3
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ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS. Pres.
CBUD - "'rl ;, �� late