HomeMy WebLinkAboutRepair gas leak Street Cut Permits Dogwo (2) Permit No. 2522 Town of South Windsor CT
Date 01/06/1999
Street Excavation Permit
Expiration Date 01/06/2000
Descrip: S. OF INT. DOGWOOD & Qtat'
Applicant Location
Name YANKEE GAS 1 I <0GUL EY
Addr. P.O. BOX 1030 ��
MERIDEN CT 06450 °
Phone (800)989-0900GAS
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Applicant agrees to ,fUr�r h � � ��
+ il�Jor the amount of bond
required ano to re i mbi ; k w
incurred by the Town fd any expensos
nab pain r1cr connection with this
Permit and that appl 1 daunt amij and k4 l �i de by the rules and
regulations for permits as�� 1 ' tt�` l y -oy, �,,o r -South Windsor's Street
Cut Pe 1 .,
Permit Manua
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* * PERMIT TC "
' %I�*' AT �'Ak:L TIMES.
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Issued � � �-
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Date Completed ` ° Inspected By
TOWN, OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2522 Contractor YANKEE GAS
Location INT W/ GULLEY Address P.O. BOX 1030
Type Work GAS MERIDEN CT 06450
Ph6h&, No. (800)989-0900
Date Insp Needed Date" Insp., IL-5(99
Time I nsp Needed Tire , nsp. 3 co
Inspected By r
Work in Progress TEMP �n in% �►.� L?�cr�ln �l�?U1
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In.put. Date
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APPLICATION
OWON OF SOUTEXCAVATION
WINDSOR N PERMIT
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm\`G.n —�L. ��`o Q--< --s L�� _ Phone No.
Address of Firm I\
Location of proposed work Q— ( ls C-\ d CA
Describe CA
Describe fully nature of permit requested L CA' C eo��
Starting date :2—cx c\ e— t \c19 g Approx.time for completion s^r o
Call before you dig no. 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 Prop.size of cut
INo.cuts
r Amt.of Deposit S by
h' (1 Cash(1 Check#
V
Cut size after Perm. Patch
��c�gvJUa d No.Cuts
Final Billing S
3' \ \
I� 5' Amt. Due Payee S
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 R€MBURSE THE TOWN OF
SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS
PERMIT AND THAT 1 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: Z i /CY C c,` i e�� ! D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES