HomeMy WebLinkAboutGas Street Cut Permits 248 Chapel Road y
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No 4305
Location I Contractit
6r YANK�E'G�S
` - Ad' ress
Type Work 112 'PX2Q^.spECTe..;H3LL RD
GAS
E WINI7uOR :C� 06088
"Phone ,No ..
:242
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Date Insp Needed
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Time Insp Needed
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Inspected By ^
Work in Progress
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Permit No.
Date 4305
09/29/2006 Town of South
Windsor, CT
on
Expiration Street Excavati
Date 09/2g/2007 Permit
Descrip; INSTALL
GAS MAIN &{`TEN'
STON :A.ITD';" LICE,"<„...:..
Applicant
Name YANKEE GAS fr: Looat` an
Addr. 112' PROSPECT HILL RD APEL
t
E. WINDSOR CT 060
025 CH RC1yD
Phone (860)292-2242
T�p;e Qf ;Gi`crrk CrAS
Applicant agrees to
required Urri dh the
and to reimbdrse the Tow Torn Q ,. Srauth Wind�Or the
incurred by the Tows £or' maa:„ :' South W3 or...f y: ,a'h aR�oiznt of bond
Permit and that ntenande
aPPlzcant or repairdr epehses
regulations Is 'fa'mllga 3nS7tnctiAn with this
for permits z�xr' k7t will Cut Permit Manual. as Yd as 'lned zn tlxe :To �' Y..the rules and
of Sough Wan s�I's Street
PE
RMIT TO $E K ,PT ON iTO
�.r• B SZFs AT ALE ,TIMES.
Issued by
Date Completed
----= _ T f
— ---------
Inspected BY
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm �C' �1�e Z S Phone No. 8G(D
Address of Firm 1 2 S 50 -
Location of proposed work
_Describe fully nature of permit requested_ .fin�{-, �'1 Q
11��f-VcCe—
Starting date 1 O L a c
Call Before You Dig No. ��9 J 5 c.' Approx. time for completion
Traffic Services Control No.
Show E ketch of proposed work or furnish
two col ies of separate drawing Indicate North This section to be filled out by
Z4 8 Town of South Windsor
Pavement Cut
No.cuts
Est.Size of Perm.Patch(s)
Est.Pvt.Thickness in.
Est.Unit Price$
Amt.of Deposit$
e) Total Due$ by
%j ( )Cash( )Check#
SI'DEWRt�j"
---T— Permanent Patch
k No. Cuts
5D C Size of Patch(s)
h 1 r2d
Final Billing
t rD400 S ed New �y�is�inct aS
Gas �al 5. � Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. Datp
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 A OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: `J Date:_ 2Z 0(o
Title: (��Q�f ii'�l 0►'1 S i nno�-� QDGc 4l S
Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES