HomeMy WebLinkAboutGas Street Cut Permits 24 Gulley Drive JaI�A.
Gas J
G�
i
- � J
_ 4
A
y
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3698 Contr ::t>rsr""YTtTRE: .., 5
Location 0024 GULLEY DRIVE Ad:i rep.s,. 112 pgOEC :,;HILL RD
Type Work GAS
.;..
2'421242
:j
Date Insp Needed
Time Insp Needed
Inspected P
e ct ed By
fiS..
n
S. W pz: R'
Y+`
.<p
Work in Pr
o r es s
9
..
Xr
— — _ 777 -
------
Permit No. 3698 Town of South Windsor, CT
Date 05/07/2004 Street Excavation Permit
Expiration Date O5/07/2005 `'""' •
Descrip:
..: . :
Applicant
PP
s
Name YANKEE GAS GI: LEY DR.IVD,i'?<,
Addr. 112 PROSPECT HILL
"R)]
E. WI ND SOR
CT 0909 X.
:...
Phone (860)292-2242
Applicant
cant agrees
f'y::f
n':r'n� . ' T... , the nyc�''�t �l amo4nt of bond
required and to reiriibrse;. Ae
incurred b <: >: :.. v.:.:
y the Towns;fa.x<,rib,�;; sxane'>rnr<; , i" :: s .gin`` :"rin.'ct
lOh with this
permit and that appl ;ca*-V is` . `
: tti . ar ? : kX.
": ' si:d. : by "t'he rules and
regulations for permits as. o' ' I: A4'd`.:.:"' '`• `" 'P 1?.t..az ttg; w :es `"Soi:'}i Windsor's Street
Cut Permit Manual. �!�°,„°>'� •
r,�
x::
* * PERMIT TO'"$E'
Is
sued by
Date Completed Inspected By
36q ly
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1S40 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $ZS.00
Name of Firm On t✓e- CL3 phone
Address of Firm 119, roSPec 401 - Fwfndsor
Location of proposed work A- -u 1 l e-u K d
Describe fully nature of permit requested e cc a e. 17 re cx f+- S Q i n
Starting date--I 0192 4 Apprmc.Wm for
Call Before You Dig N . 00 111 00 6 S 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
Indicate North prop,sae of at
No.cuts
Amt.of Deposit$ by
Cash()Check
Cut sae after Perm.Patch
No. Guts
Final Billing$
- _ 6�I�y2d -
Amt Due Payee$
Amt.Due Town$
Applicant is responsible for contacting by date
the Police DePL 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: Date: 4/5 1 JoV
Titre: OQQ�'6L f'IDY1S �5Cu1aD+'��Sn r) /i S� D.L#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
- Standard Fonns-\Permits\Street Excavation Perr t»dx -
/'n