HomeMy WebLinkAboutGas Main Street Cut Permits 315 Clark St r
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3401 Contractor YANKEE GAS
Location 0315 CLARK STREET Address 112 PROSPECT HILL RD
Type Work GAS E. WINDSOR CT 06088
e No. (860)292-2242
Date Insp Needed
Time Insp Needed > "
Inspected By ir
Work in Progress
t
5A
SOR
° .✓ t /� Date
3401 Town of South Windsor, CT
k � ate 09/25/2002 Street Excavation Permit
Expiration Date 09/25/2003
Descrip: INSTALL GAS SERVICE TO NSE
Applicant Location
Name YANKEE GAS K STREET
Addr. 112 PROSPECT HIL
E. WINDSOR CT 0 0 o k GAS
Phone (860)292-2242
Applicant agree h ff W ndsor the amount of bond
required and to re 'rbU a ou for any expenses
incurred by the To n int re in connection with this
permit and that ap h abide by the rules and
regulations for pe u o"f South Windsor's Street
Cut Permit Manual .
* * PERMIT ALL TIMES.
Issued by J/ A 6 �,t,�
1 e
Date Completed Inspected By �i� ��
45¢c,►
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
'/S j TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
(` FEE $25.00
Name of Firm N�� vl/� � Phone No.
Address of Firm 11 2- a L 1 Z- C T 4111 9, F--) p
Location of proposed work r> ti' C Z- Z-�F- N j 7- 1�4 7
Describe fully nature of permit requesIV �- o �r�V / G
tv 1 l ,0 N S� rig► " (� 0� t� ,
Starting date - Approx.time for completion
Call Before You Dig No.' Z � ` 0 1 3 Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate dra.wing
Pavement Cut
Indicate North
Prop. size of cut_
No.cuts
Amt. of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
No. Cuts
i r V Final Billing $
Amt. Due Payee$
G`f�`y� 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.
p v 7
Signed: Date:CJ jf'� 5 i z 0 t) 2.
Title: V"( L� D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc