HomeMy WebLinkAboutGas Street Cut Permits 3 Pepperbush Way �r
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3241 Contractor YANKEE GAS
Location OO63 P&,pER #SH *A Address 112 PROSPECT HILL RD
Type Work GAS E. WINDSOR CT 06088
Fhone No. (860)292-2242
Date Insp Needed Dt� Insp. , .,
Time Insp Needed � ,Insp''.
Inspected By �, f
Work in Progress
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input CA',. Date
Permit No. 3241 Town of South Windsor, CT
Date 01 /04/2002 Street Excavation Permit
Expiration bate 01/04/2003
Descrip: REPLACE GAS SERVICE FOR DUPLEX 3-5
Applicant Location
Name YANKEE GAS 000.3 PEPPY USH WAY
Addr. 112 PROSPECT HILL Rea
E. WINDSOR CT 06088 'Wo- GAS
Phone (860)292-2242
Applicant agrees to 1Ei he "fad 5 1y i ndsor the amount of bond
required and to re i mbrs t�";� Tows h Wa> r;.fr any expenses
incurred by the Town f6r, rm enarlos .caw Opa i r,,:� ,r i r� connection with this
permit and that app i i ddht - l .; 44,
�- an a 1, abide by the rules and
regulations for permits rl » d tf 'Tj f ;Soth Windsor's Street
Cut Permit Manual .
* * PERMIT TO ALL TIMES.
Issued by 24111JA I
Date Completed _ Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN BALL
HALL.
1540 SULUVAN AVENUE
SOUTH WINDSOR, CT
FEE $ »00
Name of Firm
Address of R
location of proposed Wo f , X
Describe fully rmtum of pe In t requested el
Starting date Aplr+coc.tone for
CBII Before You Dig No.Z 0 P, 51 DT Traffic Ser*m Control NO.
Sho;';;ch of proposed work or furnish �4, hied Q "� .11 Windeor
two copies of separate drawing
Indicate North Pulp.size of Cut
3; .50 No.cuts
''Amt,Of Deposit$ by.
O(ish(j Check
Cut size after berm.Patch
No. cuts _
Fiat. illlrw
77
- Amt,Due Payee$
Aft Due Town$
Applicant'is responsible for contactingby date
the Polio Del&and:C.BeY.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 EVENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE 9Y THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date:
D
Tile: / y L' D C.lk D.L#:
PERMIT SHALL BE KEPT ON 300SITE AT ALL TIMES
---Standard Form0ermitAStreet Excavation-Permit doc _ _