HomeMy WebLinkAboutGas Street Cut Permits 365 Nevers Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3727 Contra'otor YANKEE""'GAS
Location 0365 NEVERS ROAD Address 112 RQ!SPECT::...HILL RD
Type Work GAS
WIND'S ORii CT 06.088
Phone."''No (8,60)292 :2242',:
Date Insp Needed
Time Insp Needed
------------ w- i m I17
,
Inspected By
T.
Work in Progress
Date
< Permit No. 3727 Town of South Windsor, CT
Date 05/27/2004 Street Excavation Permit
Expiration Date 05/27/2005
Descrip: REPLACE GAS SERVICE ,TO HQ"TiSE
Applicant totata t-i on
Name YANKEE GAS kViR'4;ROAD `
Addr. 112 PROSPECT HILT, RD
E. WINDSOR CT 06Q8$ . ,.. f? Work
it
Phone (860)292-2242 tit
Applicant agreed Win*sct tie amciunt of bond
required and to re1mburs:e the Town of :SpxxthW rdsor to y expenses
incurred by the Town >for naxntenhee azii'rpa � work jh eonnec,G;ipn with this
permit and that appligant, is amiliar'wYth and wi71 ab"d by the rules and
regulations for permits' as:;'out�ixi d. aaa::; Pt .T?ufi Of;' South:: Windsor's Street
Cut Permit Manual.
* * PERMIT T. BF, KEPI 9N c# TX AT AI T ZMES,
Issued by Tithe
Date Completed _-- Lnsgecte y
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm — Phone No. � 7
Address of Firm Ila PS10,51'ra MU,U, I h(psb A
Location of proposed work_Vf} IoV5 Lo t krid� — p/-(�r F �n A/� FP(,�t�M N Nr SFR► i F
OPPO,;Irtr Sipe,
Describe fully nature of permit requested 1; C 3.14w L° a1,5 SERvit,�
Starting date 0 Approx.time for completion 0
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing NAM
VET,,/ Pavement Cut
Indicate NorthXESjIIU 3'y"staet }A: Prop. size of cut
L
No.cuts
Amt. of Deposit$ by
C ()Cash ()Check#
J Cut size after Perm. Patch
113 MIRK D RIVrJ No. Cuts
71 Lit l(F ST
265 WEVE6 Rb LftRK5 v1� LWd Final Billing $
171 HILLSIDEDWE� 'S Il !NORTH NUTMEG Rp '/
1-79 H ILLSibe bRIVE4 Amt. Due Payee s—
al A NWLb 1vkY(RENR PR+pawky) 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: 7 Date:
Title: / ter? D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc