HomeMy WebLinkAboutStreet Cut Permits 17 Stephanie Lane (3) 1500240 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 10/14/2015
GIS ID: 85800017 FEE: 25.00
MUNIS APPLICATION# 201501455 EXPIRATION DATE: 10/13/2016
APPLICANT LOCATION
NAME: BOUTIN&SONS ADDRESS: 17-STP-PHANIE LANE
ADDRESS: 121 WINDSORVILLE ROAD OWNER: NELIGON JOHN H&CAROLE N
BROAD BROOK, C- 06Q16 17 STEPHANIE LANE
-SOUTH WINDSOR, CT 06074
PHONE 860-623-2526
WORK DESCRIPTION: DRIVEWAY -
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A -EX NYPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN blF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
10/14/2015 3:07 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: /-5" p CONTRACTOR: �Oy�i A)
LOCATION: 17 S �eeh a l e
TYPE OF WORK: 1) j 1ti e�oc cf .
DATE INSP NEEDED: DATE INSP:_, hollG
INSPECTED BY: 0 �
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED 0 YES ❑ NO
AS-BUILT:
INPUT• DATE:
S/molloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
I-I t
AV 1JL I UA I I QN t-UK %j 0 KILI't � t-411--AV A
Appi. No, TOWN OF SOUTH WINDSOR Permit No.
S 074 FEE $25.00
TOWN HALL 1540 SULLIVAN AVENUE, 3)OUTH'fvT%"D- OP A-77 0-3 G
Name of Firm BOUTIN AND SONS CONST-'-
N- 860 6232526
121 WIND SORVI LEiR0—A5
Address of Firm BROAD ---zip Cod eQ 6 0 16.,
Location of proposed work 17 STEPHANIE LANE
Describe fully nature of permit requested REMOVE AND REPLACE EXISTING DRIVEWAY FROM
STREET TO .AGRAGE
Starting cat e—_J0-L3 _1_5 4 n 0 2
Call Beforo You Dig No2o
PLEASE NOTE: THE DEPOSIT FOR THP-PERMANENT PAVEMFNT PATCH AND CUFr:�r�5PLACEMFJAI IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST, OF THE PERMANENT PATCH AND CURB FE-PLACEMENT,INCLUDING ANY
INCREiA$ES IN PATCH AREA,CURD LENGTH,TRAFFICCONTRUIL ANO TI-Ir:; S. THE.PERMANENT PATCH.13
THE TEMPORARY PATCH LOUTIT*',Oi JI-D I�E,I-TERTH/la YEAR.
TYPICALLY COMPLETED WITHIN A YEAl--cOF
Check Applicable: 0 t No Paveme6t,.Curb or Sidewalk Cut 0 Paverren;'Cut 1-J1CurbC;A 0 Sidewalk CL(1.
0 Existing Driveway,No Changes 0 Propc)sedl)rivowayINIac.f-iing :1 Proposed.-New-iDriveway
Water Supply: 0 Public Water F1 Well Sc-tq@9e C-1 Septic
jy
Show sketch of proposed work or furnish Indicate North his section to be filled out I: Town
two copies of separate drawing N' ,cuts
E,q-Pntch Size(s) —9f
E! Pvt.Thickness in.
Patch Unit Price sf
Patch Cost
Ee;t.Curb Replacement_ft
E it.Curb Unit Price$—/ft
&A,Curb Cost$
E=it.Sidewalk Replacement sf
ESA,Sidewalk Unit Price$—/sf
Est.Sidewalk Cost
Traffic Hours hr
Erit.Traffic Unit Cost$
-.t,'Traffic Control
--Nkmt.of Deposit$
Total Due$
)Cash Check ft
Applicant is responsible for contacting the police Dept.'and C,B.Y.D
-licant is responsible
Paid By
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
I AGREE TO FURNISH TO THE T OWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH
WINDSOR 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.ASIDE bY THE RULES AND REGULATIONS FOR PeRfififfa AS OUTLINED IN THE TOWN OF SOUTH
J,1EET CUT P5-RMIT MANUAL.VVINDSOR'S ST '. I
/,Zt/I e
Signed: Print Name—--!r:
Street Excavation Permit 2014
monday 1 :00
BOUTIN & SONS PAVING COMPANY INC.
121 Windsorville Road, Broad Brook, Connecticut 06016
Tel. (860) 623-2526
8/10/15
Date of Call: Scheduled Work Date:
Date of Estimate: 8/1 7/1 5 Completion Date:
Date of Acceptance: i? 5
Name: John Neligon
Address: 17 Stephanie Lane
South Windsor
Tel:
432-2966
)0
Job Location: Off Dart Hill Rd, Debbie,
Description:
r
Quote Good for 60 Days. - - - '• -•
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract 7 � � � � Permit
ONE YEAR GUARANTEE ON WORKMANSHIP&MATERIALS. Pres.
r
CBUD l S 00 3 ` Date 1_