HomeMy WebLinkAboutGas Main Street Cut Permits 571 Graham R Permit No. 2326
Date 08/01/1997 Town of South Windsor, CT
Street Excavation Permit
Expiration Date 08/01 /1998
Descrip: EXCAVATE 1 'X1 ' VACUUM HOLE TQ 8QND SERVICE
Applicant
Location
Name YANKEE GAS
Addr.. P.O. SOX i 030 05"7{" "GF2AHAM` ,ROAD
MERIDEN CT 06450 Type caf yy��= ` GAS
Phone (800)989-0900
Applicant agrees to fur n'i sh: the` T
required and to reimb oWh "Q� �1>`�pu� Windsor the amount of bond
urse the Town' of� ,5auth Wtr`d ar fo any expenses
incurred by the Town IF r maini;'enanpe "car
permit and that applicant �s Tamil ar w�"thpand `►�� 1 " aidenbycthenrules and with
regulations for permits as Out Permit Manual . outlined irt 'the '"Town ,a South Windsor 's Street
PERMIT \ 'BE KEPI' OIN °.1QB $ITT A"T ,ALL TIMES. �
Issued by � ���
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Date Comp l emote
Inspected Sy
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 `]r r\i��LQ � ca-� c r Phone No. 9Z - 7
Address of Firm 1 ? �'G —x c� \� c� c�� L�--�. C�.�cz r
Location of proposed work 55-71 r/c,hen en +2,J
Describe fully nature of permit requested nc_cxvo.�o ► F-- _\
TL- " = Q r 'S "(—Q
Starting date 7 )Z`? /`7-7 Approx.time for completion
Call before you dig no. 9 7 Zc/Q3 Z 8 /a 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
No.cuts
` Amt. of Deposit $ by
�� �� ��\�c��� ��� <L�
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee $
Amt. Due Town $
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 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: �- " Date: /�� A —1
Title: /- / P C D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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