HomeMy WebLinkAboutGas Street Cut Permits 138 Hillside Driv Town of South Windsor , CT
Permit No. - 2229 A Street Excavation Permit
Date 07/18/1996
Expiration Date 0'7/18/1997
Descrip : YANKEE GAS WILLbO PERMANENT- PATCM. .
s
Location
Applicant
0138, tTLLSiDE DRIVE
Name YANKEE GAS
Addr . P.O. BOX of,,,-W rk, GAS
ENFIELD CT o6082
Phone (860 )292-2236
unt Applicant agrees any to fur,nlsl th¢ Town of South Windsor the amensesof bond
required and to reimbfgse ah enan � 6rr' �repa�r�4oQk � rconnection with this
incurred by the Town
by the
les
permit and that applicant 18- fam! 114 . i and =wofj"j outheWindsor' s uStreet
d
regulations for permits:,ae out� iriedin .theTowrr �
Cut Permit Manual .
* PERMI T BE 'K EP1 ON' 08, SITE AT . ALL TIMES
/ * * , •�
T 7 t i e _____----
,issued
fJ 1 Inspected By
Date Compyeted _�` -----
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APPLICATION FOR STREET EXCAVATION PERMIT
y TOWN OF SOUTH WINDSOR
Amt. Bond Required i PUBLIC WORKS DEPARTMENT —
Amt. on File s TOWN HALL PermitV.s 2' 9
Date of Expiration � 1540 SULLIVAN AVENUE Date _
Ins. on File (,,)—Yes No SOUTH WI SO CT Permit Expires •-
Expiration Date FEE
Name of Firm
Address of Firm I:Z � Phone No. 9 ^�
Location of proposed work Ltib {7Q r
Describe fully nature of permit requested 60-4—S g�
Starting date 7'�.�•� — --_ -- � D�y
Approx. time for completion �. __
Call before you dig No. 70MA 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
t i Pavement Cut
O Indicate North
Prop. size of cut �j
tLn—i
No. cuts
Amt. of Deposit $_ by
O Cash O Check #—
P/CtQ&, 8rpCty Cut size after Perm Patch
............r`.'.�.,"".�.... No. Cuts
...w. •��rwwrrwr.�p r
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 funish 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: �� Title: e
D.L.L.# Date: r _
PERINIT SHALL ON ALL TIMES
APPROVED: DATE:_ lalt
TO INEER
FOR INSPECTOR: Date work started Date Completed
Signed Date
WHITE - PERMIT PINK - ST. SERVICES
YELLOW ENGINEERING `""" GOLDENROD FINANCE