HomeMy WebLinkAboutGas Street Cut Permits 632 Graham Road Permit No. 2325
Date 08/01/1997 Town Of South Windsor, CT
Expiration Date O8/01/ 1998 Street Excavation Permit
Descrip : EXCAVATE 11X1 ' VACUUM HOLE TO BOND SERVICE
Applicant
' Name YANKEE GAS Location
Addr. P.G. BOX 1030 0 �2 `GRAHAM ,ROAD
T 06
Phone M800)989ERIDEN C09G0450
TY� ai ward GAS
Applicant agrees tO furnish the, Tornbf South Winc!
required and to re i mbu rSe the .:Town �O f Se�uth Ws7 r1�g�r ds any expenses
sor the amount of band
incurred by the Town for maintenance Qr- rspair .y�gr in connection
permit and that applicant p uses
pp cant ��� fam '� i�r w�t�°and wi��� 1 ,-ab=ideb with this
regulations for permits as oat 1 i Tied i'n the Ta .D South Windsor ' s ythe rules and
Cut Permit Manual .
Street
* ? PERMIT J . .KEPT . OM.
i1OR �STTE AT, ALL TIMES.
Issued by ' -
T i t e
Date Compi!etJd
Inspected By
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r
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 `le- r-\i'�e r-v C -S Phone No. Z 9Z - 2 7 S
Address of Firm 1 \ 7 K2rO 14 e �� �'-,N,
Location of proposed work L 3-L feet rr
Describe\fully nature of permit requested
Starting date 7 129 `7'7 Approx. time for completion 4-
Call before you dig no. 9 -Z Z-7 Z 8/�/ 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
(Z-G- A\\C-1-C�VN a—-\ ��(` G� Amt. of Deposit $ by
C < ()Cash O Check#
Cut size after Perm. Patch
No.Cuts
Final Billing $
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:
Title: T / ' /c/ D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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