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HomeMy WebLinkAboutGas Main Street Cut Permits 65 Beelzebub Permit No. Date 2290 02/ 10/1997 Town of South Windsor,, CT E ni:) i ration Date 021 10/ 1 9g, Excavation Permit Desct-ip; Applicant Name YANKEE GAS Location Addr. P.O. BOX 339 ENFIELD CT 06052 65 BEELZEBUB ROAD Phone ( 560)292-2236TYPe Of W+ rk GAS Applicant agrees to furnish tfre lawn of Sa required and to re i mbu rse th �ut�+ �i`i�ds�r the amount of bond incurred by the Town for Town of .South W•tndsor for any expenses ► �nt`enance .©r" repa i r wr rk r,n connection with this permit and that applicantsat �iiar wfti and wil amide b regulations for permits as outlined in the Tpdr1 Of Seth Wi Cut Permit Manual . Y the rules and ndsor s Street * PERMIT 1"O BE KEPT Gil "".JOs STTE,"AT ALL TIMES. Issued by -- ES. Gate Comp 1 eted Title Inspected By Qoo APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR • PUBLIC WORKS DEPARTMENT TOWN HALL } 1540 SULLIVAN AVENUE SOUTH, WINDSOR, CT FEE $25.00 Name of Firm Phone No. Address of Firm i cq Des tune of permit requested /4'X G✓4 y/¢% //v /'e O f�t� u�'Or Y �.Q/�s � �lL�• a i- X. C Starting date_/P1 y �9 �''1 Approx.time for completion Call before you dig no. Traffic Services Control No. Show sketch of proposed work or furnish To be rlled out by Town of So. Windsor two copies of separate drawing Pavement Cut Indicate North Prop.size of cut ~ 7-YN/C-4c //v SE.e T N W G,�s vrc`1 .7-/,O'/1 cpuc r/ ae- Se-e vrc i_ No.cuts 1 6 0 S C� Amt.of Deposit$ by O Cash O Check# I( Cut size after Perm. Patch I 20 s S v f I No.Cuts IFinal Billing $ G Z B o 13 ,� I I Amt. Due Payee $ s m ! 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: Title: /�/uCr- + D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES