HomeMy WebLinkAboutGas Main Street Cut Permits 513 Deming S 1
TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 33g5 Contractor YANKEE GAS
Location Address 112 PROSPECT HILL RD
Type Work GAS E. WINDSOR CT 06088
0,0 e No. (860)292-2242
Date Insp Needed
�n i oy
Time Insp Needed
Inspected By
Work in Progress ee 1�—
�.. Date �'/3-��,�
Per 't @I�. ""' 3356 Town of South Windsor, CT
,'DAt ' 07/31/2002 Street Excavation Permit
Expiration Date 07/31/2003
Descrip:
Applicant Location
Name YANKEE GAS M STREET
.Addy. 112 PROSPECT HILL
E. WINDSOR CT 060 GAS
Phone (`860)292-2242
Applicant agrees th i n sor ,!the amount of bond
, required and to rei T uth 9,W or any expenses
incurred by the Tow ten epa k n connection with this
permit and that appli 0 1 a ? bide by the rules and
regulations for perm ' t cf '
outh Windsor's Street
Cut Permit Manual .
� a t
* * PERMIT ALL TIMES.
Issued by Sop . V e
Date Completed Inspected Byt,�s�
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm X1 foK r CQ p Pone No.
Address of Firrfi EG 1 . D ef io
Location of proposed work 4 0 1 KD ZAIQ -
De 1 fully nature of permit requrlzlt
C d'
p? rlar
Starting date -- 22 —72,Q Approx.time for completion
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To bellied out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North Prop.size of cut
No.cuts
r Amt.of Deposit$ by
C
O Cash{)Check#
P.Gs.
Cut size after Perm. Patch
C.G.. .
No. Cuts
0 9 J
Final Billing$
AC
SL , I Amt. Due Payee$
Amt. Due Town$
Applicant is responsible.forcontaaing L�� .�3 by 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�-dL— !Nl► �. —acN"`� Date: : a(—�z 3`��
Title: .- �',L�C� D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc