HomeMy WebLinkAboutGas Main Street Cut Permits 779 Avery St TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2405 Contractor YANKEE GAS
Location 0779 AVERY STREET
Type Work GAS Address P.O. BOX 1030
MERIDEN CT 06450
Phone No. (800)989-0900
Date Insp Needed
Date .= nsp
Time Insp Needed Time' Insp.
Inspected By
Work in Progress
Input Date
—---— ---------�
- PermI hdci . 140b Town of South Windsor, r �
Date 03i G2/ i 998 Street Excavation Peer,Mlt
Expiration Date 03/02/1999
Descrip: RPR MAIN INT.
Applicant. Location
Name YANKEE GAS ;
= �� Y STREET
Addr. P.O. BOX 1030 � ,
MERIDEN CT 06460 r° � TN
Phone (800)989-0900 g
> gF ?� 'WOr` � AS
s f f{ ( $
Applicant agrees t fuj erns
f he40rrri �� Vi� or the amount of bond
required and to reimbor
bwn th Hit " r=..
r any expenses
incurred by the Towns� benan�e
+ 3 pa i h ` kr connection with this
permit and that app 1 7 ant a4 ,�1 andA, �1 ti de by the rules and
regulations for permits astt;l` � 0 ,
Cut Permit Manual .
� cif -South Windsor' s Street
* PERMIT T& B < �" 'fT ' L TIMES.
Issued by
Date Completednspec ted By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm f�/}N/t F� �r/�s Phone No. a2 92, 2 2-S�-2—
Address of Firm /lag �/�0 5 P��T h`/ G f'- C -iNdS 6'-C
Location of proposed work f/ 11C2
Describe fully nature of permit requested
Starting date Approx.time for completion 3 /yi s�iifi'S
Call before you dig no. c/t3 O 70 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North *-- Prop.size of cut
77 No.cuts
Amt.of Deposit$ by
(1 Cash(1 Check$
Cut size after Perm. Patch
No.Cuts
Final Billing$
/-,Nc)3 k Amt.Due Payee $
/Z Amt.Due Town$
Applicant is responsible for contacting
the Police Dept.and C.S.Y.D. 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:- ;2-2 66 �S
Title: D.L.B
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES