HomeMy WebLinkAboutGas Street Cut Permits 55 Old Farm Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3560
Cont.xa''ctor YANKE2"GAS
Location 0055 OLD FARM ROAD Type }lddre 112 RROSPEft:,,HILL RD
Work GAS
WIND'SO-M:CT 'f 6.088
Phone,No C6 ;A)2:92 '2242 <,
Date Insp Needed
--------- — D a t 2x pCB
Time Insp Needed
Inspected By
Work in in Progress
Input Date
—sC�
14
Permit No. 3560 Town of South Windsor, CT
Date 08/06/2003 Street Excavation Permit
Expiration Date 08/05/2004
Descrip:
Applicant Location
Name YANKEE GAS 0Y085 ,QLD FARM ROAD,
Addr. 112 PROSPECT HELL RD ''
E. WINDSOR CT �6688e `i�f STOYJS GAS
Phone (860)292-22'42
Applicant agrees to, furtl;La the Toiwn'txf S �t :h Windsor the,,amdunt of bond
required and to reimburse :thy Town cs 'South I i dS,d fox,'"any'sae enses
incurred by the Tow4 for maX0 a ance or repair Work �n 4hnaction with this
permit and that apply dant `'�s fat�il3d f!i aaa will �i' e by 't}�e rules and
regulations for permits as..outlined. i:::g,kkt .Qwn'o,f South. Wandsor's Street
Cut Permit Manual.
* * PERMIT TO`BE I 'P.:7 ON 'i$OB SI3E AT.;,j�LL T'TMES...
Issued by Inspected By
—
Date Completed -- � ��
APPLI_CATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm �'4 h/Kra 1! fis Phone No.
Address of Firm //-z P,e41 PEC-r. le-C
Location of proposed work
01-0 ralz-m 2
Describe fully nature of permit requested 1'ZEPArRC/n/KAS S'E 2 r c tf //V S E 01
Starting date 66"d'1 ?0 0-3 Approx.time for completion O$ - /S'Z v e 3
Call before you dig no. &0 D 3 3/O e4 7 O g Traffic Services Control No.
Show sketch of proposed work or furnish iN To be filled out by Town of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North {/I► Prop.size of cut
s No.cuts 47
Amt.of Deposit i by
W
A (1 Cash O Check x
/ EC G,/W�� Cut size after Perm. Patch
S —�
No.Cuts
Final Billing S
Amt.Due Payee of
/f-i�y � Amt.Due Town $
Applicant is responsible for contacting l— x�f'
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.
Signed: Date:
TitletspEG1.41-•S; - PEST/o.JS r �vPPa.�� D.L.r
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES