HomeMy WebLinkAboutGas Main Street Cut Permits 179 Commerce TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3664 Cont :a� r" AfI(E£' Gd�S
Location �` pig :
Fad res. g!112 i?.:RO P.EC::.HILL RD
Type Work GAS �s � h
INT$SO
��� .'.:.E%f.::.:W..:. R•'�SCT 66:0 8 8
S'
3 ':x
Date
I ns
P
Ne
eded d ed
-------'
d S h
Time Insp Needed �lme I
�Y
Inspected By
` =y"-°etc w h
Work in Progress ' `
S �v� `nth
r k,
1 + * n<
77 7—
'y. t:' '•
In
—
4
Permit No. 3664 Town of South Windsor, CT
Date 04/06/2004 Street Excavation Permit
Expiration Date 04/06/2005
r}
Descrip
Applicant %.'
off::.
Name YANKEE GAS "( COMMERC WAY.":::
Addr. 112 PROSPECT HI L
^«
vw�
E. WI NDS OR
CT 060
-f3
Phone (860)292-2242kr;:ry..,
Ap
plicant f
pp cant agrees':: t`d ,.�, e Tc��q�i;rg'�e•'��, �:"� Wind's 5�;<<`tl�e� aciYo#int of bond
required and to reib "� ::;;'
w
incurred by the Ton f. ; ' ' aril z. ..?€.,?.,;«;:z
; ?� "nT<" ai rrlc.:::> na.eonne'ctipn with this
permit and that aPP1z:cf
u:: : :<;>: •;;:>< : b by'°: 0::e rules and
regulations for permi'�.s as; dt.t: iri >?"<: ter•.:. :.:. :>, :,• . ...
�,�,��%�?'F�S� ,}�o'f"Sgr�I G+1; ncis`or s Street
Cut Permit Manual.
;
* * PERMIT TOQ2 SK 6:V..>
Issued by -----�_L��"=— /C✓ — .: —x' :! ,.:.: .,;:::,,�%'
Date Completed Inspected B C _
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
!S r:
Name of Firm Phone No. �, `� _� !�
Address of Firm I I:� l �i'r_�� H�l� ('gyp C � � /•��� ,�
Location of proposed work_
Describe fully nature of permit requested_ To
a,N j trU1 P
Starting date +
. 0 Approx. time for completion
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
Est. Size of Perm. Patch(s)
I Est. Pvt.Thickness in.
1►
Est. Unit Price$
Amt.of Deposit$
I Total Due$ by
1
1 ( )Cash( )Check#
( �n t✓!h �(� IV) Permanent Patch
61u, � No. Cuts
Size of Patch(s)
1
f Final Billing
�- Amt. Due Payee
J I nl 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.
Signed: <��' v�� hn` Date: C�v
Title: Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES