HomeMy WebLinkAboutExcavate gas service trench 972-978 Plea 700143 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
STREET CUT PERMIT
DATE: 09/12/07
GIS ID 72909999XIA
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MUNIS APPLICATION 'Ax; < FEE:
# 200701474 "' .00
IRATION DATE:
09/11/
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NAME: yANKE
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APPLICANT AGREES TO FURNI SH THE T6WI4:L}F UTH: �`'';F'`
THE TOWN OF SOUTH WINDSOR FOR ANI'`IEY�I,SI3tlt" 4 B.O<tID REQUIRED AND TO REIMBURSE
IT,. 7 ! (FOf :1AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE ?RIGt1NT'iS Fy1IAR:: Fi AND.Gf1 pBiDE BI, E RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF S(3[J II., 3��RYSYS "Al
>>T'' R11kI MANUAL.
ISSUED BY ""f
DATE INSPECTED INSPECTED BY
9/12/20072:27PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1"/ CONTRACTOR:
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: 'Z lay
INSPECTED BY:
WORK IN
PROGRESS:_ w U/4
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AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
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The material contained on thismap she'be
considered proprietary to Yankee Gas and user TITLE: _— —
(which is defined as any person or entity
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The material contained on this map shall be
considered proprietary to Yankee Gas and user TITLE:
(which is defined as any person or entity
(CALL BEFORE YOU DIG - CT) 09/12/2007 09:19:43
12-5G YANK/G -BB -C1 -GV
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-----------------------------------------------------------
***** ROUTINE *****
Time: 09:19 Date: 09/12/2007
Request #: 20073701995 Previous Request #:
Latitude: 41.8089257
Longitude:-72.5788768
Town: SOUTH WINDSOR
Address: 972
Street: PLEASANT VALLEY RD
Nearest Cross Street: NORTHVIEW DR
-----------------------------------------------------------
Type of Work: EXC TO INST GAS SERVICE
Area is Marked: YES
Remarks: STARTING 4FT BEHIND THE CURB LINE IN THE FRONT OF THE PROP
GOING TO THE BLDG
-----------------------------------------------------------
Start Date: 09/15/2007 Start Time:07:00
Caller: MIKE HANECAK
Call Back: 7:30-4
Phone Number:860-292-2247
Fax #: 860-292-2269
Alt. Phone:
Email:
Contractor: YANKEE GAS SERVICE CO.
Address: 112 PROSPECT HILL RD
City: EAST WINDSOR
State: CT
Zip: 06088
-----------------------------------------------------------
Excavator Doing Work: SAME / RH WHITE
Issued To: Arrived:
Issued Date: Time Left:
Issued Time: Completed By:
Issued By: Completed On:
Call Back
1)Date: 2)Date:
Time: Time:
By: By
Person Contacted: Person Contacted:
APPLICATION FOR STREET EXCAVATION PERMIT "?Oo(�3
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 40(iC.<
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm K e e Gci S S c e v ; C eS C C .
Address of Firm t r Z Phone No. ZS 2 - 2 2 k f 7
S'�� s � -- 1-1,1( R d sfi
Location of proposed work 9 7 Z - 5 7 g V (e a S { V c
Describe fully nature of permit requested Ex <<, v` , „ (
he�� n � c � 6 k, rje 4 41s Se /' VI cP �rP.1C Y� 1 /1 a�4SS
r r o 'Cl 4 V✓1 i I` U ve U
Starting date S'e of. 2 O u 7
Call Before You Dig No. 2 o a 7 3 7 0 9 4S Approx. time for completion_ JV o V. 2 0 7
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section to be filled out b
Town of South Windsor
Pavement Cut
No.cuts
Est.Size of Perm.Patch(s)
Est.Pvt.Thickness in.
Est. Unit Price$
S e-e ci 4\ eA- S k e C V, Amt.of Deposit$
Total Due$ by
( )Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contactin
the Police Dept.and C.B.Y.D. �tP
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: Q !
Date:_':'IL/ 1-7
Title:_ (� Cu n S�• j eG`n
Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES