HomeMy WebLinkAboutGas Street Cut Permits 141 Hillside Driv TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 2960 Contractor YANKEE GAS
Location 0141 HILLSIDE DRIVE Address 112 PROSPECT HILL RD
Type Work GAS E . WINDSOR z"'T 06088
Phone No. ( 860 )2922242
Date Insp Needed Date f resp;. _
Time Insp Needed Ti me Insp'. _
Inspected By -- _
Work in Progress
Input` _ Dates
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Permit No. 2960 `town of South Windsor, CT
Date 05/03/2000 Street E:xcavatiori Permit
Expiration )ate 05/03/2001
Descr i p: INSTALL GAS SER',/ICE
Applicant Loc:at i on
Name YANKEE GAS 0141 HILLSIDE DRIVE -4
Addr. 112 PROSPECT HILL RD
E. WINDSOR CT 06088 Type of Work GAS
Phone t.860 )292-2242
Applicant agrees to furnish. the Town of South Windsor, the amourot, (:,f bond
required and to reimburse the Towai cof South Windsor for any expenses
incurred by the Town for maintenance or `repair work in connection 1,410) triis
permit- and that applicant is familiar with and will abide by the rules ana
regU lations for permits as out`-lined in the Town of South Windsor ' s Street
CiAt Permit t Manual .
PERMIT TO BE KEPT OWN JOB SITE AT ALL TIMES.
Issued by
_ �_t..J�, -- T t l e
Date Completer _ Inspected BY
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
'1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
e
FEE $25.00
Name of Firm_ Y)51S+fKe_E" 6�x Phone No.
Address of Firm // PoOJ'PEi
Location of proposed work
Describe fully nature of permit requested -nys � G1ES sevt c�
Starting date 5--� .- Approx.time for completion i,D
Call Before You Dig No.. QS 8T3 8d.3 Traffic Services Control No.
Show sketch of proposed work or furnish - N To be- [led out by Town of South Windsor
two copies of separate drawing
pc� A0, .q Pavement C
Indicate North �3`
i Prop..size of cut
No.cuts
t
k-z—FhOM967o.G's4.T VE V O!e_ Amt.of Deposit$ by
i {)Cash O Check#
Cut size after Perm..Patch
No. Cuts
`l��t S'icL Z)e. Final Billing$
OU6 Pay€ $,. .
Amt. Due Town$
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: - Date: - 0
Title:-- D.L.#•
,PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc