HomeMy WebLinkAboutGas Main Street Cut Permits Buckland fro 1
Permit No, 23g2-
Date 12/02/ 1997 Town of South Windsor, CT
Street Excavation Permit
Expiration Date i 2, ;�;r,r j g98
Descrip: GAS MAIN OtA BUCKLAND i=ROM .OAK,LA'ND TQ DEMING ST .
App 1 i cant
Locat I or-+
Name YANKEE GAS
P.O.
Addr. 60X 1030
BUCKLAND FROM OAKLAND TO DEMING
MERIDEN CT 06450
Phone ( 800)989-0900 TYpe of -WorK GAS
Applicant agrees to furni Ser,the Town of So
required and to re i mb uth frJi ndsor the amount of bond
�a rse the .'Town of South W i rdsor for any expenses
incurred by the Town f6r maintenance or repair w.or"J ' 7n' connection with this
permit and that applicant 7s familiar with 'and will regulations abide by the rules and
nual .per~,nits as outi7nea in the Town of Socath Windsor ' s Street
' Cut Permit Manual .
i
* PERMIT TO Bg KEPT ON .JOB SITE AT ALL TIMES.
_-
Issued by -
r --? _ --- - Title
Date Completed ,_— Inspected By
,_�
iJ Y
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR �r
PUBLIC TOWN DEPARTMENT
1540 SULLIVAN AVENUE 77�v
SOUTH WINDSOR, CT .�3eq- 7j
FEE $25.00 �—
Name of Firm er "' S 'Ir'(C C, -fie` Phone No.
Address of Firm
Location of proposed work 2GjNd?tJw i ,'Tc r /+v cS�'. !
(5---671N' :ems cat 2200 -6 - Ia�eo t!
Describe fully nature of permit requested .27VJ7-,@-e L-
��-s
Starting date Approx.time for completion vZ A171 /2 J;
Call before you dig no. ?7L1 L/O el7sT77 Traffic Services Control No.
Show sketch of proposed work or furnish Tb be Filled out by Town Of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North
Prop.size of cut
No.cuts
Amt.of Deposit 4 by
O Cash O Check#I
Cut size after Perm. Patch
No.Cuts
Final Billing$
Amt.Due Payee 0
Amt.Due Town 0
Applicant is responsible for contacting
the Police Dept.and C.S.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.
.c Signed• Date: /Yd'?�. lql 19
C
Title:
�-Zt/sf '1 D.L.#f
-
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES