HomeMy WebLinkAboutGas Street Cut Permits 414 Niederwerfer r . 'own or South Windsor , CT
Permit No. 21 el6
Date 02/10/1997 Street Excavation Permit
Expirat.ion Gate 02I1��'i 1998
Descrip:
Applicant; Location
Name YANKEE GAS 0414, NIEDERWERi"Ei; ROA
Addr. P.O. 80X 339-'`
ENFIELD CT 06082 Type of .Works GAS
Phone ( 860)292-2236
Applicant agrees to fur�nish, thel Town of South Windsor the amount of bond
required and to reimburse the 'Town of $6uth wincisor for any expenses
incurred by the Town for maintenance or repair work m connection with this
permit and that applicant is, familiar with and will abide by the ru'ies and
regulations for permits as autiined in the Town of Soutfr Windsor ' s treet
Cut Permit Manual .
PERMIT TO BE KEPT i?N JOB ••SITE AT ALL "z I m E S.
Issued by '—�~ "" _ _ Title
_-�.�-',•`�-- - -- -
Date Completed _____�__--_--- :Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
c� / TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm //�/✓/c�'�' �,�S Phone No. f8 6'v P a -.2 2 S`
Address of Firm C- tfiC C 'e X. rr`-) ,-2
Location of proposed work N / 9- 7 .41
rJs d ,cx -I �/ �/ / ' ,�✓5'a �,. �/ `�'6, Sa '9 . S J 0,
Describe fully nature of permit requested �'jr c9vrR?r i .� .Q c /�B w� y f}i✓�o
G'/�4SS / ����4 tg G .�2 • o<w io i2 ',9""' cEs'�2vecc-
Starting date 1W,09 /'S'S' 7 Approx.time for completion
Call before you dig no. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
7-ypeG4 L /N S E i2T N r P" S` V!o E
TNP-00 G oLl� S E�:✓eG 46, No.cuts
Amt.of Deposit$ by
I�I O Cash()Check#i
Cut size after Perm. Patch
No.Cuts
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 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: Date:
Title: Z D.L.#i
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES