HomeMy WebLinkAboutGas Street Cut Permits 11 Pam Lane TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3192 Contractor YANKEE GAS
Location Address 112 PROSPECT HILL RD
Type Work GAS E. WINDSOR CT 06088
Phone' No. (860 )292-2242
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Date InsP Needed ate Insp.. -' 1J
Time Insp Needed 'inr�e �3n"gip,: :
Inspected By
Work in Progress � � w
Date
Permit"'No. . 3192 Town of South Windsor, CT
Date ,,, t, �s 08/29/2001 Street Excavation Permit
Expiration Date 08/29/2002
Descrip: INSTALL NEW GAS SYSTEM
Applicant
Location
Name YANKEE GAS t Q01 1 �''pAM LANE
Addr. 112 PROSPECT HILL RD
E. WINDSOR CT 06088 Tye, ,of, Work, ,GAS
Phone (860)292-2242
Applicant agrees to furnish the TO Ao South-Windsor the amount of bond
requi red and to reimbu -tha, 117.Own f youth W.in,8,0 'for any expenses
incurred by the Town far m4i,-0-^t 'n t e r°.;;.repai r, rs rk,: n connection with this
permit and that appl icantN?ie: 'f''ami 1 I. r, tth and ,wall abide by the rules and
regulations for permits as,,,,out Iio* : Town ':'f 'S uth Windsor's Street
Cut Permit Manual .
* * PERMIT TO BE KJEPT 00 J'09 SIT8'AT' ALL TIMES.
Issued by
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSORf CT
FEE $25.00
NameofFinn NAAISPP 6)AS Phone No. 0-2qZ--7-ZvA
Address of Firm WE nr os,ippr+ vkm 2
Location of proposed work, jj&ty L^
Describe fully nature Of permit naauesbed ne . rapt 50t.l,z e
Starting date 9 o Approx.On fora mpletio
Call Before You Dig_Ne, 0013 H u'L 9 e i Traffic Services Control No-
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies.of separate drawing
# 1� Pavement b-A
Indicate North Prop.size of cut
No.cuts
"Amt of Deposit$ try
O Cash O Check `
Cut size after Perm.Patch
No. Cuts
Final Billing$
?At.,Ln Amt Due Payee$
;- - -- Sxr
Amt Due Town$
A licant is responsible for contacting by 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 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:a, Date: �512910/
Title: Fiy/cl fi e C,in Li An D.L#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
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Standard Forms\Permits\Street Excavation Permitdoc