HomeMy WebLinkAboutGas Street Cut Permits 63 Old Farm Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3562
Cont;rac't'or YANIt 'E'<GS
Location 0063 OLD FARM ROAD Address 112 '?:RQS,PECT::;,HILL RD
Type Work GAS $,;, WINI�SQR`CT ''0>.6088
Phone''No (Q ;O)292 `242
Date Insp Needed
Time Insp Needed _-- —_ — Tim::
Inspected By
Work in Progress _l � �L C ' �, °A� tr+ ,' s•' �h«
u
- --�--- -
Permit No. 3562 Town of South Windsor, CT
Date 08/06/2003 Street Excavation Permit
Expiration Date 08/05/2004
xx
Descrip:
Applicant "Locataon
Name YANKEE GAS 0463. .,OLD FARk RQAD,
Addr. 112 PROSPECT HILL RD
E. WINDSOR CT a6Q88 Tya,e of 5bi dAS;
Phone (860)292-2242
xj
Applicant agrees to futiiis. the T& of o2th Windsor the:..amaunt of bond
required and to reilnkStXs >.the Poway �s South Wxidscr fOa '`anypenses
incurred by the Town for ineantenance' or repair W'0rk::,-,:::iaiVcohn4.erti,on with this
permit and that appl` cent `3s fauMT— ", W3 1 abide :by tYie rules and
regulations for permits aS. outlined %a th2., gv of Svut'h Windsor's Street
Cut Permit Manual.
* * PERMIT TO"'BE IC 'P,T ON SOB SI3yE AT. ALL T1IES.
Issued by _--
Date Completed Inspected By : �
APPLI_CATION FOR STREET.EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm VA Phone No. 8(oo a &Z `
Address of Firm !/2 f a s pEe >—. 11.C EAST— w s.4'5S--04e O 6 6 8 e
Location of proposed work
3 0 L 6 r 2M ,ZIS
Describe fully nature of permit requested 2EFs-AC i n/K A S 66,e r c .2 4, /N S E k- A.)C,
AlEr� pi Pf- JN 4762 01-6 a,J;� .
Starting date 66-6"/ Z 60_3 Approx.time for completion 0$ - /$-'Z ca 0 3
Call before you dig no. c9 n O 3 ���;? to 7 (o 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 I Prop.size of cut
3 Lv I No.cuts_
u
Amt.of Deposit C by
(1 Cash O Check i
sy Cut size after Perm. Patch
'u � i�a t,E G'2a-s s �
No.Cuts
0 J_ �/�2M ►Z !� Final Billing 6
Amt. Due Payee S
✓ts M,¢��( Amt.Due Town 0
Applicant is responsible for contacting
the Police Dept.and C.S.Y.D. S X ' /�a c>✓ �rhSS 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 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:
Titlet-SIIPEei flf Q000/1 0-7— D.L.N
PERMIT SHALL BE KEPT ON JOSSITE AT ALL TIMES