HomeMy WebLinkAboutGas Main Street Cut Permits 435 Buckland Permit No. 2454 Town of South Windsor, CT
:pate 06/22/1998 Street Excavation Permit
Expiration Date 06/22/1999
Descrip: ,
Applicant Location
Name YANKEE GAS ,�p � � 4 5; k KC D ROAD
Addr. P.O. BOX 1030 n
4
MERIDEN CT 06450 type c7or1e~ GAS
Phone (800)989-0900
Applicant agrees to Fur y °tt� t f Sc� �1��x iW�Ck�or the amount of bond
required and to reimburse f°r'own c�f"!�O*h W d#S r.W f,Qr any expenses
incurred by the To i€ a rep r� " "th connection with this
permit and that a V1Ay
i de � ru l es and
r e 9 u 1 a t i o n s for permits% astth V ind"sor' s Street
Cut Permit Manual . } _* * PERMIT TO KIT dN JtB SITS AT ALL TIMES.
Issued by �kjA 1-
Date Completed Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2454 Contractor YANKEE GAS
Location 0435 BUCKLAND ROAD Address P.O. BOX 1030
Type Work GAS MERIDEN CT 06450
Phone 'No,. (800)989-0900
Date Insp Needed Date 'I,n" sp
Time Insp Needed Time Insp
Inspected By
Work in Progress �Avlet,
Y,Y
Input" Date
APPLICATION FOR STREET EXCAVATION PERMIT a�
PUBLIC WORKS E ARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm_ y 0.n K Qq GCS
< S _Phone No. '�q - 7-Z�`7
Address of Firm
Location of proposed work 4 r
r
Describe fully nature of permit requested
Starting date 1 ZG\ Cl 8 Approx.time for completion t r"srz o
Call before you dig no. `I $ .rZ� Traffic Services Control No.
y3s
����� To be filled out by Town of So. Windsor
Pavement Chi --
Prop.size of cut
No.cuts
1 1
—�— Amt.of Deposit$ by
O Cash()Check#
�35
Cut size after Perm. Patch
No.Cuts
Final Billing$
Amt.Due Payee$
Amt.Due Town$
by date
Ra
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: ' �_�G� ..`_ / p
/ Date:
Title: �jL Iql D.L.#
PERMIT_SHALL BE KEPT ON JOBSITE AT ALL TIMES
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