HomeMy WebLinkAboutGas Street Cut Permits 446 Niederwerfer Permit No. 2287 town of South Windsor, CT
'Date 02/ 10/1997 4 Street Excavation Permit
Expiration Date 02% 10/ 11tj5
Descrip:
Applicant Location
Name YANKEE GAS 0446'"NIEDERWERFER ROA
Addr. P.O. BOX 339
ENFIELD CT 06082 Type of GAS
Phone ( 860292-2236
Applicant agrees to furnish the , Town of South Windsor the amount of bond
required and to reimburse the "Tower of ,uth Windsor for any expenses
incurred by the Town for m intenance or"' repair ,work _ in' connection with this
permit and that applicant is fami liar w.i th ,and w i'l l , ab"+de by the rules and
regulations for permits as outl fined in the Town of 'South Windsor ' s Str.eer.
Cut Permit Manual .
* * PERMIT TO BE,:K,EF'T """E}NV':40l vi""fiE AT ALL TIMES. � * " •�
Issued by �' _ Tit1e - .- -- --
Date Completed �� Inspected By
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 S Phone No. �'6c9 �02/`� o2
Address of Firm �/sZ �RoS�, G T l'7�/ C ,Q✓> 7 w i iv® r c-, iz
Location of proposed work N /2 t.v,G,e .�C iC /�,ea e ,qz-7-
":x "T ✓ y / ,-✓ya $,. y6. Sa '9 , s moo_
Describe fully nature of permit requested _6'jc cRriff o ffi✓Ao
SS �/ A2�'14 C2 J-- .Q • o,w io i2 A71�C/ac e X-14S
Starting date zW,*9 1194 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-#P-00 6 oL 0 S e g No.cuts
f S ` Amt.of Deposit S by
Iif (1 Cash()Check#
Prza ,'rsw cds 422Qiti v��� Cut size after Perm. Patch
G� S /22 A-/N I�1 No.Cuts
Final Billing S
Amt. Due Payee $
/.0 0 - 2 wE R .QA-V
Amt. Due Town $
Applicant is responsible for contacting
the Police Dept.and C.S.Y.D. by date
1 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.
-Sign ad: Date: 9-/0 `-` 2
Title: D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES