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HomeMy WebLinkAboutGas Street Cut Permits 98 Overlook Road Town of South Windsor . CT 286'. t Street Excavation Permit `rermi`t No. `' r,9/ 1. 7/ 1999 ._ a - Date . Expiration mate 0906/2000 Descrip: INSTALL GAS SERVICE Locat i or, Applicant 0097 OVERLOOK ROAD Name YANKEE GAS Addr . 112 PROSPECT MILL. RD Type of Work GAS E. WINDSOR CT 06088 Phone (860).292-2242 Y j sh -the Town of,,South W i=7dsor theeamensesof bond Applicant agrees ,o furn maintenance or repair work in connecby thenrules and required and to r�eimburs�; the Town of South Windsor for an incurred by the Town for ma permit and that applscant` is familiar with and w ; 1 South in p far permits as outlined in the Town of South �Jindsor ' s Street regu l at.i ons Cut Permit Manual . * PERMIT TO BE ..KEPT ON ,JOB SITE AT ALL TIMES. t ✓� � 1=- Title issued by - - _ _ _ -- Inspected BY o Date cmp l eted — -- - --- APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm 1Cee a5 Phone No.— Address of Firm Prmj2eC� Location of proposed work er Describe fully nature of permit requested I n 5�a I Starting date Approx.time for completion_ 3`,00 ern Call before you dig no. Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of So. Windsor two copies of separate drawing Pavement Cut Indicate North __rr �r Prop. size of cut No.cuts Amt.of Deposit$ by ()Cash()Check N Cut size after Perm. Patch No.Cuts ©VGiZ Lob I<- Final Billing S 3x3 C�5 areo— 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 RIE11MBURSE 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:[j/-7/ 7 Title: D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES