HomeMy WebLinkAboutGas Main Street Cut Permits Sele Drive a�rmif No. 2.412 Town of South Windsor, CT
lt,o 04/06;1998 Street Excavation Permit.
�p i rat ion Date 04/0,6/ 1 ,999
;scrip :
A p p 1 i ;ant; Location
Wme YANKEE GAS S1 ALE` DRIVE Al' DEMING
idr . P.O. BOX W30
MERIDEN CT 06450 Type of, Wor' GAS
lone (800)989-0900
App 1 i cant agrees to furlhl sh;, the TQwn of Sou h Windsor the amount of bond
required and to reimburse the: Town of Sough Wfrideor- for any expenses
i ncurred by the Town fur .m'a i ntenance o,,r repair Work ' i n� connection with this
permit and that app 1 i cant i.s farm i.ar wi th 'and wi l 1 ate' r de by the rules and
r-egu'lations for permits as out'iined it the ToWn ,ofi South Windsor' s Street
Cut Permit Manual .
C,l * PERMIY _o BE KEPT ON JOB 'SITE AT ALL TIMES .
.slued by I_I- {._ _ Fit.i e
)ate Compl�tjd _ _- _'.._ Inspected BY ____ -------.__--_------.____-_-
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� - APPLICATION
OWON OF SOUTEXCAVATION
WIN SOR N PERMIT
PUBLIC WORKS DEPARTMENT �
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm (o.��¢ Q �O�S o_ c �t : �cLS Phone No. 01
Address of Firm n d So r
Location of proposed work t -��� �� 5 \cam—�c "i(L
Describe fully nature o ermit requested cam\
Starting date Pl\ c . 'z \ClRF2 Approx.time for completion \
Call before you dig no. 9 `0 \ Z 0 Q(Z y R Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North ( 7 Prop.size of cut
dNo. cuts
Amt.of Deposit $ by
O Cash(1 Check N
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee $
Amt. Due Town S
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 RFIMBURSE 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: Date
Title: / T / /J t D.L.+
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES