HomeMy WebLinkAboutStreet Cut Permits 19 Wentworth Drive 1700095 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 05/22/2017 r,
GIS ID:93300019 '+ FEE: 25.00
MUNIS APPLICATION# 201700588 s EXPIRATION DATE: 05/22/2018
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APPLICANT Y. ' ` �Ey} LOCATION
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NAME: BOUTIN&SONS 19ADDRESS `k14VEITWORTH DRIVE
ADDRESS: 121 WINDSORVILLI'ROAD OWNEg tiR�OG DANIEL T&LYNN M
BROAD BROOK,C'9 QfslO1 ' F ;. 19 IV WORTH DR
7 SOUTH WINDSOR,CT 06074
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PHONE 860-623-2526 z s
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WORK DESCRIPTION: DRI�'YEAY
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APPLICANT AGREES TO FURNISH THRWTOWN OFFOI7'TH WII�DSI�SHE AMD,UNT�F B.(3ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AI+IY1XPEI+ISE5 INCIJRRI;D l 'TIC$ OWN�'OR 1VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TIE APPLI AhIT S l~A II IAR�'ITIi.JS SWILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWNDF SOTI�Wl1IIJSQ STREET CLT`T'EIZIMIT MANUAL.
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ISSUED DATE INSPECTED INSPECTED BY
5/22/2017 10:45 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO::._.L.Z,LOLL CMAC OR: i •
LOCATION: iAj(--,,1j:L0i2ctL •
WE OF WORK•
DATE INSP NEEDED: DATE INSP.._
INSPECTED BY: ��7 .' '
WORK IN
PROGRESS' 14 XJL
SEPTIC TANK.PUMPED,SMASHED,FILLED WTNESSED ❑YES ❑NO
AS-BUILT.
INPUT. w- DATE`
s/mo![oym ms 2amTown of south Windsori(gm N'REF0RT14
THURS.PAY
1 :00pm BOUTIN & SONS PAVING COMPANY INC.
121 Windsorville Road, Broad Brook, Connecticut 06016
Tel. (860) 623-2526
4/1 6/1 7
Date of Call: Scheduled Work Date:
Date of Estimate: 4/2 0/1 7 Completion Date:
Date of Acceptance: �� I
Name: DANIEL. JW (sj
19 WENTWORTH DRIVE
Address:
SOUTH WINDSOR
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Tel: 860 833 3913
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Job Location.
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Description: /P
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Quote Good foDays. n� " • • - -• -•
Special Attention: 112 Payment Upon Starting, Balance Upon Completion.
Contract ��'�` ! Permit '
ONE YEAR GUARANTEE ON WORKMANSHIP&MATERIALS. Pres.
CBUD a C)k—) -- -aQ 0 -01(0-5 Date E5