HomeMy WebLinkAboutGas Street Cut Permits 60 Griffin Road hermit No. 2.485
Date 08/13/1998 Town of South Windsor, CT
- Expiration Date 08/13/1999 Street Excavation Permit
Descrip:
Applicant
v
' Location
Name YANKEE GAS
Addr P.O. BOX 1030 � GRI"EFI �2
MERIDEN CT 06450
Phone �i* .t �rs GAS(800)989-0900 �� - yp
Applicant agrees tq furnzhh the '� r crf Sc3a indsor the amount o
required and to re i mb rse.,,they °down f bond
incurred by the Town for ma mace vr� h Wr�dor 'for any expenses
permit and that app 1 i cant rpa r` rcrk .l`n connection with this
re'gu 1 at i ons for am#1 nd, ri �� � ab i de by the rules and
permits �a ► � n,ang1 �eth Windsor's Street
Cut Permit Manual.
E ' �
* * P �RMIT TOPT fAJQB 3T_ AT ;ALL TIMES.
Issued b h :
C'Z(Il�
Date Complete�l
�. / Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC TOWN DEPARTMENT gr
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm n ; ¢ Phone No. 7
Address of Firm 'P� —�S �•
Location of proposed work ,
Describe fully nature of permit requested
Starting date _ / Approx.time for completion_
o. q$3 Zd Z$ Z Traffic Services Control No.
Call before you dig n
FShow 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 S by
O Cash O Check#
Cut size after Perm. Patch
No.Cuts
�r a•�„oS2� C\ci5 5CC�I\CQ,
J Final Billing S
Amt.Due Payee S
Applicant is responsible for contacting Amt. Due Town
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 1 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: T. P, �� Date: 8�/3 Aw
Title: e- ///e e/
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES