HomeMy WebLinkAboutGas Main Street Cut Permits 51 Gail Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3918 ,r Con,�sr'�or,FYANK ' S
Location 0051 GAIL LANE U► Ftadre; 112"' RQSPEC'f.,HILL RD
Type Work GAS .le
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Date Insp Needed %s+
Time I n s p Needed
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Work in Progress
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Permit No. 3918 Town of South Windsor, CT
Date 03/31/2005 x3u,«,.: Street Excavation Permit
Expiration Date 03/31/2006 '" s
Descrip: INSTALL SHUT OFF UALV9,BETWFvEyE ,SIIJJE34LK»'
Applicant f( ;v `'
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Name YANKEE GAS /�1 s
•"9�`� GAIL I, 1E..
Addr. 112 PROSPECT H1Lh',RD
:`fxr:^.?: .; .:.
E. WINDSOR CT 6 "8$
Phone (860)292-2242 ••
Applicant agreed ` #u i s
r ..f? b. . "• sa ...' he`amiunt of bond
required and to remr °T.::..,.::" - , y. .: '
incurred b >. {ys�la/ :• .» , :.%"` Y?: expenses
Y the Toftxr' �zi: nare"ox° � "yonmecton .with this
permit and that app .i alit T.S. the rules and
regulations for perm5;,ts a;s`':6.uh Iiirac�;�: ;' "e'''
Cut Permit Manual. a
Sf S Ch�1--hd`sor's Street
PERMIT TC3:, Fy/ �"P I dar�� � T ZaT L T:II S.
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Issued by
Date Completed Inspected By �,,
g"A I lu" rvK 5 I KLET EXCAVATION PERMIT j T 1 y
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm . L i
Address of Firm BLS Phone No. cF t
Location of proposed work i �n
Describe fuller nature of permit re quested
G1 S� + ��, � _ - ic ; ch
Starting date L.
Lq C'j
Call Before You Di No. �, n Approx.time for completion h C
g -� L I`-� G r,try ! Traffic Services Control No.
Show sketch of proposed work or famish
two copies of separate drawing Indicate North This s71 �b out by
�j Todsor
Pavemen
No.cuts
Est..Size
Est.PvL in.
Est. Unit Price$
Amt.of Deposit$
Total Due$ by
Cash( )Check#
I I
-Permanent Patch .
No. -Cuts
Size of Patch(s)
I _(
Final Billing
.S l�r=4.�f(-►J
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
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: ,�� k
Date:
Title:_"' L �'
+ Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES