HomeMy WebLinkAboutGas Main Street Cut Permits Avery Street (4) H
Per t . 2490
Date =O Town of South Windsor, CT
09/17/1998 Street Excavation Permit
Expiration Date 09/17/1999
Descrip: GAS MAIN CROSSING AT CHASE ORCHARD
Applicant Location
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Name YANKEE GAS
Addr. P.O. BOX 1030t RflGE RD AT AVERY ST
MERIDEN CT 06450 x` � ' yyjAS
Phone (800)989-0900
Applicant agrees tc� fu 0141.7h,,the `Own w
o- 1ior the amount of bond
required and to re i mb r�s Tbw :pf th a rc0ar -fdr any expenses
incurred by the Town tOnaM0e J )ai rk connection with this
permit and that appl in y fame 1 �
regulations for and �� ide by the rules and
9 permits oWtl � o # �?t;jth Windsor's Street
Cut Permit Manual . „
* * PERMIT TO E -E ( �_ } l�fl'TE q;�' i L L TIMES.
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,Issued i b y � �•� , - _ IT" `i e
Date Completed Inspected By
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2490 Contractor YANKEE GAS
Location TALCOTT RIDGE RD AT AVERY ST Address P.O. BOX 1030
Type Work GAS MERIDEN CT 06450
Phone' No. (800)989-0900
Date Insp Needed Date rasp,
Time Insp Needed Tmnsp
Inspected By
Work in Progress p
Ihput Date 5
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR yqa
PUBLIC WORKS DEPARTMENT
TOWN LL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm C/V Phone No. Z'
Address of Firm 'L 'T'.�
Location of proposed work
Describe fully nature of permit requested 1`C-L.
Starting date —31 Approx.time for completion_
Call before you dig no. 940391 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
P��d./yl0 No.cuts
Amt.of Deposit S by
O Cash O Check#
n �201��10 CvT
Cut size after Perm. Patch
No.Cuts
_ Final Billing$
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Amt.Due Payee 8
S
Applicant is responsible for contacting //O �t Amt.Due Town
the Police Dept.and C.B.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:
Title:—
D.L.#
U 0
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES