HomeMy WebLinkAboutReplace 3/4 PDA steel service with 1/2 P Permit No. 3730 Town of South Windsor, CT
Date 05/27/2004 Street Excavation Permit
Expiration Date 05/27/2005
Descrip: REPLACE GAS SERVICE .TO HOUSE-FREPAI:R VkIV.EWAY
d.
Applicant Loeat:ion
Name YANKEE GAS �02 A&NOLD WAY
Addr. 112 PROSPECT HILL Rb
E. WINDSOR CT 0608$; T q WoXT G.AB
Y�
Phone (860)292-2242
Applicant agrees; to: furnzsh the down cy� S6.uth Windsoz the amount of bond
required and to reimburse the.2own of S�zi[. h Wardsor Enr any expenses
incurred by the Town—for maXxa eiiaxcty 13r repair .rz4 k h oorsnact,ion with this
permit and that applicaiat a S '-anvil Ar wi :h and-W-111 ab�r e'by the rules and
regulations for permitE> as ou:tlined;:: h the T�y+n: of S4uth'Windsor's Street
Cut Permit Manual.
* * PERMIT TO BE; KEPT ON cIQBIL AT AIL
{�
Issued by __— -- CRC Titj e-
Date Completed ►
p ----------------- .Inspee�ed B (Ilk
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 37 0 Contractor `YANKHE SAS
Location
1lddress 112 PROSPECT,HILL RD
y r
Type Work 3
E; WINbSOg CT '0::6088
Phone No 18a.:j 292`2,242 '.
Date Insp Needed ------------- Date* Ix; p
Time Insp Needed _—_---_-----T Time Insp,
Inspected By
_ 4
Work in Progress W&UaM(
-----------------------------
------------------------------
—
Iriput
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Phone No. ` 7
Address of Firm Ila Pilawyer HILL-. A
Location of proposed work 0V5 to Array — 00 GEM AT s7
o c)'pbgirtr StPe, dF v)(,PlAr -
Describe fully nature of permit requested t (; 3. SreeL sFRU+u? w, `` �L5 5EfzUi(@
Starting date 61110Y Approx.time for completion -Joh 0
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing ��
Pavement Cut
Indicate North LYL5TI Id3'y"Stew :. Prop. size of cut
No.cuts
Ron
Amt.of Deposit$ by
3
C—h5> I A)V Cash()Check#
Cut size after Perm. Patch
113 MARK D Mid 79-srar RmD
No. Cuts
71 L&1:E ST✓
3r 5 AIEVERS Rbj fS LItRKSfVR LA406
s 11 NORTH NUTMEG R� � Final Billing$
HtLiSrAE D�iiVE
179 H ILUSIDE UiVI:f Amt. Due Payee$
WLb WAY(RENR PAO- I-Y)J Amt. Due Town$
Applicant is responsible for contacting by date
the Police Dept. and C.B.Y.D.
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: �— --y
,/ Date:
Title:_ /,�`ty rc era, za, s 4'`, D.L.#•
PERMIT SHALL BE KEPT ON 308SITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc