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HomeMy WebLinkAboutGas Street Cut Permits 35 Stephanie Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No, 4058 Location ^3 Contr ¢ o Y'ANE SAS s $ 7 `112> 32Q�SPE�E. HILL RD %Type Work GAS gfNA0g-`,CT',:%6088 1 3on� b (8 6 2,;Z42242 ZP Date Insp Needed Dot Time Insp Needed yAM — j Inspected B _�4— �� q,�::.. •.;�' �..: 45 Work in Progresslx r ix ------------------- a Permit No. 4058 Town of South Windsor, CT Date 08/04/2005rv' Street Excavation Permit Expiration Date 08/04/2006 Applicant PP i';x 'a•' L©c:a` .i'n Name YANKEE GAS :' } STEPHAIA�TE<• x' Addr. 112 PROSPECT HILL-g r •r: " �:. E. WINDSOR CT Q60 8' .. Phone 860 292-2242A. Applicant agree9. 't'v' f11 'r `sitY$"the T ry. xf 3i = yp t;Iie a)naiznt of bond required and to re :mt#aus '<;T f &or f3Y,::aaj•:>:eXP�'nses incurred by the Town} fc5rin-ect'i�n with this permit and that appl`:a at`` s. tl; z g '• 'ryi.c hy''`tke rules and regulations for permits as CiFed { s,r�f $Qiirlds'or's Street Cut Permit Manual. Asa * * PERMIT PT UN;;�3O8% T7� 1� ASP, TIMFrS. Issued by Date Completed __------^—_— Inspected By r PHQNE GA1,L FOR r O TIM A. M O F PHfi1TaEt} r ❑FAX PHONE ❑MOBILE ,,.may c ��� �bt�c• �;Zupl . `y S�ak2 P S G 6rA5 come,o I �v►l r, } 3� oAck- >r 0.3-aS APPLI&TION FOR STREET EXCAVATION PERMIT �/OS78 TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm ��1 k ; " (,A J Phone No.-S, 6 1 Address of Fi l 12- if r--b I t",t'C-,r 1111 R-� , J-", C , Location of proposed work 3 , 5- J I r ( r Describe fully nature of permit requested Ta Mt}4t . GAt` 0- Q F-aeqP KJ'T• Starting date i �✓ Approx.time for completion D A'V Call Before You Dig No.-2-0 J .7/ 0 22 2 '7 Traffic Services Control No. Show sketch of propos aad work or fumish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor # 3 Pavement Cut No.cuts Est.Size of Perm. Patch(s) I� �L��. Est.Pvt.Thickness in. Est. Unit Price$ C Amt.of Deposit$ f— S �� r k. rh� NL-,'EDA) Total Due$ by ( )Cash( )Check# Permanent Patch No. Cuts Size of Patch(s) Final Billing Amt. Due Payee Amt.Due Town By Applicant is responsible for contacting 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 TO1kEIMBURSE 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: r-'AOL --�' Date: Title: `tom/ L "i.�O Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES