HomeMy WebLinkAboutGas Main Street Cut Permits 28 Gail Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3916 Contr. '"YI1QI{E
l: .:::;GAS
Location 0028 GAIL LANE �����
"res,� 112.<.:,'�PROrSP:M-.2' HILL RD
Type Work GAS
• f :SOX CT`.Q6088
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Date
InsP Needed
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Time In S'
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Inspected By
Work in Progress _ _ 3 � a
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• Permit No. 3916 Town of South Windsor, CT
Date 03/31/2005 Street Excavation Permit
Expiration Date 03/31/2006N..y Y' M•
Descrip: INSTALL SHUT OFF VALyY $ T NsTREPfEOALK
Applicant 1f 'tr.;' u^ "'
f I�oction
Name YANKEE GAS y CiAII YiANI
Addr. 112 PROSPECT HI, L RD
E. WINDSOR CT d6Q88 ems@ pf Wq GAS y
Phone (860)292-2242 � t
f8 8 r
Applicant agreesQuxsli the;''cr§ } t $th Widph .amount of bond
required and to rdijubUrbp0 own o£ Safz exg�
T #` dsor J
� .� �Q� e�9y� nses
work
incurred by the Tawn „£off n dontkon with this
permit and that aphlican
,ham ...gl° d :..�lY; ? e by ''tfie rules and
regulations for ih'. or's Street
ds
Cut Permit manual. � s
PERMIT"TO'
Issued by
Date Completed
�.��•�-► ww rUK s i KEET EXCAVATION PERMIT 91
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00 -
Name of Firm c�;
Address of Firm Phone No. C
Location of proposed work
Describe fully nature of perm't requested Il� f I ((;f ��� ti�<<_�lid
Starting date k] k 5
Call Before You Di 'No. '� Approx.time for completion /
g � 1��L' r Traffic Services Control No.
Show sket_ of proposed work or furnish
two copies separate drawing Indicate North This section to be filled out by
- - Town of South wndsor
Pavement Cut
No.cuts
Est..Size of Perm.Patch(s)
Est.Pvt.Thickness in.
Est:Unit Price$
Amt.of Deposit$
Total Due$ by
)Cash( )Check#
Permanent Patch .
No. Cuts
v Size of Patch(s)
Final Billing
_ ] t Amt. Due Payee
Amt.Due Town
By
Applicant is responsible for contacting
the Police Dept.and C.B.Y.D. 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
PERMI71,
D IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:PERMITS OUTLINED
_ 1_ �,LC ,� /")-5
Date:
Title: � `� �;�_ ,�; � �`. �•. )�(� ,
Driver's License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES