HomeMy WebLinkAboutGas Main Street Cut Permits Sullivan to Permit No. 23:191 Town of Soutr) Windsor , CT
Late 12/02/1997 Street Excavation Permit.
Expiration Date 12/02/ 1998
Descrip: INSTALL MAIN FROM SULUVAN TC, OAKLANU RD( RTE . 30 )
A �, i :►rat L.ocat i on
Name YANKEE GAS Gt7MMUI�II`) �' RO. -SULLTV,AN TO OAN;LD
Addr . P. D. BOX. 1C130
MERIDEN CT 06450 Type of "Wor k. GAS
Phone (800 )989-0900
Applicant agrees to furnish,` the Town of South Windsor the amount of bond
required and to re"r mburse th0, Town oi" South W i ntls`or "" fo'sssr" any expenses
incurred by the Town for maintenance or. t" pair wa,rk .in connection with this
permit and that applicant i s f ami'l i ar with and will abide by the rules and
regulations for permits as outlined in the . Tarn ..'of South Windsor ' s Street
Cut Permit Manual .
' * PERMIT TO aE KF-PT, OW JO8 SITE AT ALL TIMES.
Issued by r
Title
Gate Completed _-__-- `__ _ Inspected By
' F
r
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR �(
PUBLIC TOWN DEPARTMENT
110
1540 SULLIVAN AVENUE Z 7
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm ��, � -7iUC` Phone No.
Address of Firm //� c�S9E � fCLiN�r
Location of proposed work
200 " 312 /ytat v,tJ1 "q J
Describe fully nature of permit requested --Z7V�S W-4•t— 6,+J 1'ZXL-'
Starting date Approx.time for completionT�fJ:
Call before you dig no. q Zq YO-::�— 6 Traffic Services Control No.
Show sketch of proposed work or furnish Tb be filled Out by Town Of So, Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut '
No.cuts
Amt.of Deposit= by
O Cash()Check#I
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt.Due Payee 0
Amt.Due Town 1
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. by date
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. _
Date: / /,) aq 19
Signed:
ti
Title• ��L�' Gj �'"� D.L.#i
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES