HomeMy WebLinkAboutGas Main Street Cut Permits 12 Commerce TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4079
ocation 0012 elqt?WCE Wr33Z Contractor YANS
Type Work GAS Address 112 p20S.pECT<;$ILL RD
' E; WINDSOR, CT 0088
Phony. No ($G4325 ..*
Date Insp Needed
Date Ia�$p �
Time Insp Needed _
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Inspected By
Work in Progress -- �n — '
Permit No. 4079
Date 09/12/2005 Town of South Windsor, CT
Street Excavation Permit
Expiration Date 09/12/2006
Descrip: GAS SER
VICE
Applicant
ocat,io-n
Name YANKEE GAS
Addr. 112 PROSPECT HIhi � 1 �AMMERC WAY
E. WINDSOR CT 06Qgg
Phone (860)292-2242 Tye of :torn
:
Applicant agrees' to fern sh'
required and the Tocyn p ;, Svth Wind �rr the
to reimburse tla�' own ' out,hn [nount of bond
incurres.
d by the Town. feareatSP
permit dance or repair �rbr prises
p and that applxcanE fs '€asilar ?nxt X??: orin ;ctibn with this
regulations for permi .s a �t:asxd 'ia7l abide b
Cut Permit Manual. a edl�e ' qwn of Y t1i'e rules and
South Wi:n'dsor's Street
t
PERMIT TO BE KIPS ON 'JC3B
aITkE T ,SDI,.TIMES.
el
Issued by
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,Date Completed
1 _
---------- I.nspected By / ----
APPLICATION FOR STREET EXCAVATION PERMIT -/a 19
` TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm Y y9 A&L L r%9 S Phone No. g to Z `� C/
Address of Firm //Z P iiz 0 S E< < jy: t l i,, V:A S i W ov j Soil.
Location of proposed work_ 4-' C c�r✓r ,vt �? L r4 j
iZ
Describe fully nature of permit requested_ w.S j e9 L c G,g 5 S L 2 v« +
Starting date 7 v5 Approx. time for completion
Call Before You Dig No. Zon S 37 0 ,31 It Z- Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts .,y�oO
Est.Size of Penn.Patch(s)
-��
e �
GA5 Est. Pvt.Thickness in.
I 5�r LC Est. Unit Price$
I
I Amt.of Deposit$
J
Total Due$ by
C o -1 rv1 6 2 WA � _ ( )Cash( )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
III Final Billing
Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contacting 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.
—�1
Signed: c fl I 12 SO iy Date: S
Title: L Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES