HomeMy WebLinkAboutStreet Excavation Permit 107 Pine Knob D I
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~ TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2521 Contractor YANKEE GAS
Location 0107 PINE KNOB DRIVE Address P.O. BOX 1030
Type Work GAS MERIDEN CT 06450
Phone No. (800)989-0900
Date Insp Needed Date Ipsp,�
Time Insp Needed
Time tlnsP. �4fS
Inspected By
Work in Progress caoullG for - 'VA tCA tovks
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P�Prri. . 2521
Date 01/05/1999 Town of South Windsor, CT I
Street Excavation Permit
Expiration Date 01/05/2000
fDescrip: EXCAVATE TO REPAIR GAS LEAK
Applicant . Location 1
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Name YANKEE GAS
1r `y1�7JENOB DRIVE 1
Addr. P.O. BOX 1030 g j
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MERIDEN CT 06450 y.
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GAS Phone (800)989-0900 '
Tf Wrk
Applicant _agrees to
the a Sbth i ncor the amount of bond
required and to reimbdrs ono l`own
incurred by the Town i+Qr mant$naac�` r�� �pakor any expenses
permit and that applian connection with this
regulations for fam 1 � i h an W lf1 , abide by the rules and
permits as, u11t1d `in 0 Tow1� L�:f nth Windsor 's Street
Cut Permit Manual .
* * PERMIT TO "BjE K. PT TIMES.
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Issued by
T1 ci�.r�
Date Comp 1 eted - 1 (5h-)
111spected By
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APPLICATION
OWON OF SOUTEXCAVATION
WINDSOR N PERMIT
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm CX C'\ Q. 9- c'l\c.Q-S Phone No. Z 5 7
Address of Firm \VZ—� Ca s r, c y\'\ \� V. �)�'-,8o f
Location of proposed work k ,a7 �:,Q 1l�o'�J��c �� rz
Describe fully nature of permit requested c��1 �tQ C Q,SZ1 ¢rQ.
Starting date 1-Cb in- q`1 Approx.time for completion
Call before you dig no. I`\1)11�m i Ch 13l'A 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
1 <D'-7 No.cuts
Amt.of Deposit S by
O Cash O Check#
Cut size after Perm. Patch
I
\/ J No.Cuts
14 P �A�c es A, 3 ' Final Billing S
Amt.Due Payee $
Amt.Due Town $
Applicant is responsible for contacting
the Police Dept. and C.B.Y.D. � m L1 by date
I AGREE TO FURNISH TO THE TOWN 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 ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
Title: , !7 9 I n C e D•L•#
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES