HomeMy WebLinkAboutDriveway Street Cut Permits 882 Avery St i'OWN of SOUTH WINOSOR INSPECTION REPORT
Permit No. 2948 Contractor YANKEE GAS
Location 0882 AVERY STREET Address 112 PROSPECT HILL RD
Type Work GAS t:: . WIPit)Sc R CT 06 088
Phone No. ( 860 )29 '--2242
Date I nsp Needed _._ Date I nsp.,._,-_- -
Time I rsp Needed ----_- - Time L nsp.
Inspected By !_
Work in Progress
I nowt _ Date
'--_- ----__._----------- - ----------. -------_.. .e.,__..._ -
Permit No. 2946 down of South Windsor, CT
Date 04/ 12/2000 Street excavation Permit
Expiration Date 04/12/2001
Descrip; EXCAVATE TO INSTALL GAS SERVICE
Applicant Location
Name YANKEE GAS 0882 AVERY STREET
Addr . 112 PROSPECT HILL RD
E . WINDSOR CT 06088 l ype or Norte GA i
Phone ( 8f') )292--2242
Applicant agrees to, turnish the Town of South, Windsor- t")e amount of band
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 app i grant Js familiar with and will abide by the rules and
regulations for permits as outlinevi in the Town of South Windsor 's Street
Cut Permit Manual .
* PERMIT TO BE KEPT ON J08 SITE AT ALL TIMES.
Issued by
-----.- T it l e
Date Completed --------.__-__.-__-_--_-- ._ Inspected By _--- --
APPLICATION FOR STREET EXCAVATION PERMIT a
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1S40 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $2S.00
Name of Firm Phone No, dZ- 225-7
Address of Firm t C
Location of proposed work `b M 2 ± .i e r S
Describe fully nature of permit requested
S Q--t v
Starting date P1:s-,z \ ��� �, m Approx.time for completion
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 Prop.size of cut
$$Z No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt:Due-Payee
- 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.
Sign �� Date:
L Title: / ,C i' e- D.L.#•
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc