HomeMy WebLinkAboutGas Street Cut Permits 9 Gray Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4065
Con ;ra'Ctor YANKEE""'C4AS;
Location `0002 GRAY ROAD
F ddx es, 112 PROSPECT^<IiILL RD
Type Work GAS ..
6:6,0,8 8
Phone"Nq E$��kf292 ;2242 ,;
Date Insp Needed
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Time
Ins Needed
Inspected By
Work in Progress — �
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Permit No. 4065 Town of .South Windsor, CT
Date 08/19/2005 Street Excavation Permit
Expiration Date 08/19/2006
Descrip: RELOCATE SERVICE
ApplicantX.
Locat,koi
Name YANKEE GAS t3009.3aRAy RGA�`
Addr. 112 PROSPECT HILL.;2D .
E. WINDSOR CT 0£08$< Pyle of F7or1 GA.S
Phone (860)292-2242
. .....:::..
iij
Applicant agrees to furn�s t,#�e ow cif St�utk .,Wind;' o' the ,amount of bond
required and to reimburse 4 down .Cxf bush : Uids.�.r fair any'e's enses
incurred by the Town for;. manteance pr xepa�r wox x �Catin` o n with this
permit and that applicant is famal3ar vrY Ord :wYl] alarde;•by ttie rules and
regulations for permits aq outlxned, rywof Sdufh .Wncisor's Street
Cut Permit Manual.
* * PERMIT TO '73:E'`KP .O,I)T:., . ..:`. i ';TTM 5.
Issued by t
-Date Completed _--___ Inspected By
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:'." �.rCi.. '� -7^ f.7 i
1 SQU 'H WiNL1SR7 A � _
:'WORKS I PARTMENT
TOWN HA#;l. ..
1540,SULLIV -N;AVENUP
SOUTH WINDSOR,CT.06074.
• - FEE �2�.00 . ' - • '
_ Name of Frm N alik
2 . J'. phone No.
Address of F!r g2 2 S8
Location of proposed work q z
Describe fully Pn#ure of permif requested
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R CPF
Starting date -
-- A rox tune for portpletlQn. 2 Y
Call Before You.pig No � '3/
Traffic Services ContrW'No. ..
d Showetch`6i,p 7777777
roposetl wok or furnish777
tuvo ° ies of separate drawing
Indicate North This.E4, 00 to tae filled cuE
Town of Scut ndso
Pay,er"M Cut'
of Pe --7777777
rm .Patch(s)
SIc :Est Pvt,:Th�Ckn06
Uo F?nce$
S Aii of Depot$ �3
4 cTl `�t Total Due
y �- by
=j Cash
( )Check
Qerrnaoeitt Patch
-- � r-� C
Side of Pakch{e)
axxY/C
yy - - Finai Bil#ing
Aft Due:fayee
Amt.i) Town
By.
-App-i, iii is:responslble-for cb6tadng -- - — — -
the Police De t:and G BY D, r ' 3 t . Oate
! AGREE TO FURNISH TO THE TOWN OF S; UTH WINDSUR THE'AMOUNT OF'BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SOUTH WINDSQR FOR ANl( EX . ySES INCURRED BY THRvTQWN FOR 'MAINTENANCE OR RERAIR VYQRK IN
CONNECTION;WITH TH13 PERMIT At ,I AM FAMILIiAIf�VyITf.AhjD WILL BY THE RULES AND REGULATIONS FUR-
PERMfI S AS OUTLINED IN THE TOWN OFUTH WINDSOR'S"STREET C.UT PERMIT MANUAL,
Signed..
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D ex'
at
Title �- - � - --
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Driver`s License#:
• PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES