HomeMy WebLinkAboutStreet Cut Permits 72 Paper Chase (4) 1300104 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/16/2013
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GIS ID: 69000072 ��, FEE: 25.00
MUNIS APPLICATION# 201300658 EXPIRATION DATE: 05/16/2014
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APPLICANT -MAR � LOCATION
NAME: BOUTIN&SONS
RE5-9. 72 AP1R CHASE
ADDRESS: 121 WINDSORVILLEp / j OBERT N&JACQUELINA R
BROAD BROOK, CT�644-1 % �71 PAPER CHASE
WNW INDSOR,CT 06074
Aff-
PHONE 860-623-2526 ' ,
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WORK DESCRIPTION: DRIVEAV-
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THE DRAIN LAYER ASSIGNED TO THIS ITT HA A VC �ISS TE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTkj TIE AI—,T—x SIP AFC ARK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,A QI�EQRE� S AI T ATTACHED CONDITIONS.
ISSUED BY' DATE INSPECTED INSPECTED BY
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1 " O CONTRACTOR: "gnu -= u
LOCATION: P �G
TYPE OF WORK: r' wQ
DATE INSP NEEDED; DATE INSP: 1
INSPECTED BY: 2
WORK IN
PROGRESS: . e r�
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT:_ DATE:
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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 $25.00
Name of Firm Boutin & Sons Const. Co. Phone No. 623-2526
Address of Firm 121 Windsorvi e Roa roa rook, Conn
Location of proposed work Paper0-
CIA- .
Describe fully nature of permit requested
Starting date Approx.time for completion (dAC-
Call before you dig Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
(J Cash(J Check#
Cut size after Perm. Patch
a 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
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 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.
7 - 71 c91. ► -�
�ned:
�f. -1, _ Date:
Title: �L.Gi'�% D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
---'SATURDAY
� •` '�� BOUTIN & SONS PAVING COMPANY, INC.
121 Windsorville Road, Broad Brook, Connecticut 06016
04/22/13 Tel. (860) 623-2526 Consumer Protection Reg.#500258
Date of Call: Scheduled Work Date:
Date of Estimate: Completion Date: � �
Date of Acceptance: <�/ 7oI 3
MR. TOWER
Name:
12 PAPER CHASE DR
Address::
SOUTH WINDSOR
I
PHONE 860-729-1428
Tel: P
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Job Locaation:
Description:
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PLEASE NOTE: DUE TO CURRENT VOLATILITY OF LItUID AS T PRICES,
CONTRACT PRICES- WILL BE SUBJECT TO ANY PLANT MATERIAL C Gr.
Quote Good for 00 Days. •
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Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
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Contract
ONE YEAR GUARANTEE ON WORKMANSHIP & MATERIALS. Pres.
00
CBUD /J
Date C "