HomeMy WebLinkAboutGas Street Cut Permits 32 Grant Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3145 Contractor YANKEE GAS
Location '' Address 112 PROSPECT HILL RD
Type Work
E. WINDSOR CT 06088
Phone No. (860)292-2242
Date Insp NeededD ate Insp: C.,
Time Insp NeededT,irn� Inp,
Inspected By
Work in Progress
Input _. Date
Perna, t .No. Town of South Windsor, CT
07/10/2001 001 Street Excavation Permit
Expiration Date 07/10/2002
Descrip:
Applicant Location
Name YANKEE GAS p 403 GRANT ROAD
Addr. 112 PROSPECT HILL RD
E. WINDSOR CT 06088, Type of Work GAS
Phone (860)292-2242
Applicant agrees to `i~urrt r$h..th0 rn cad t6uthWindsor the amount of bond
required and to reimbwrse "Town .:of Sou � fdor for any expenses
incurred by the Town for a t n ee q h epai rk.,.in connection with this
permit and that applicant s ;farm � arh and", by the rules and
regulations for permits as-)" "oul�,itd °iD .Tom o
South Windsor's Street
Cut Permit Manual , >�
a
* * PERMIT TQ , E KEPT btu,, "' SITP qT AI:L TIMES,
Issued by
Titled
Date Comp 1 eted ®1 d 3 b?� Inspected By
APPLICATION FOR STREET EXCAVA
TION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT.
FEE $25.00
Name of Firm Phone No. - a9 -ems
Address of Firm
Location of proposed work
Describe fully ture of perm' requested v
Starting date a Approx.time for completion
Call Before You Dig No. tR0,0 Jol T.ZT_Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement Cut
Indicate North #$3z Prop. size of cut
i oT ( 6 No.cuts
Amt.of Deposit$ by
�tib 2 GBb� 3' S \19 O Cash O Check#
Cut-size after Perm. Patch
No. Cuts
Final Billing$
VVI
Amt. Due Payee$
F Amt. Due Town$
Applicant is responsible for contacting by date
the Police Dept.and C.B.Y.D.
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:- J��i Date:
Title:— .042&7�ok D.L.#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc