HomeMy WebLinkAboutRepair gas leak Street Cut Permits 91 Pi 700027 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 04/18/07
GIS ID: 72000091 '' - FEE:
MUNIS APPLICATION# 200700463 >: €:.. .00
EXPIRATION DATE: 04/17/08
APPLICANT
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NAME: YANKEE GAS .:, YtEs `.
M '.0]=PTE KNOB DRIVE
ADDRESS: 112 PROSPECT HILL
•
CT p6 $8
:INS"T�1�TOB DR
IVE
EAST WINDSOR,
"SQ fH'WINDSOR.CT
74
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02 22 9 242
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SCRIPTION:
CRIPT IO N: FIX
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APPLI
CANT
NT AGR
EES
STOF FURNI
SH TH
E TOWN
..•,,,.,;,<..° vIREQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN 'EN 1N " 1 p q lYIt11ATTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THL AI"PL C `I :F Y1 g $IDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN ODC3I>WIfiI^'..S T �>I?I R1v1IT`IVIANUAL.
fS SUED BY DATESi 'EI✓ ET INSPECTED BY
4/18/20072:06PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: Z0 Q 0 a1) CONTRACTOR: �a x e CAS
LOCATION:_ Pt` kvwl Wat ADDRESS:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: S
WORK IN
PROGRESS:_ ,ve C o rt � c ��- in d e r-f ' 3•, x 7
Cr A- S L e�.k
INPUT: -- DATE:- 1 ( � o I
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17' .7511 ST I P 1959
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The material contained on this map shall be considered TITLE: plot_menu field 1
proprietary to Yankee Gas and user(which is plot—menu—field 2
defined as any person or entity who has received p
the map through sale,purchase,exchange,gift, Ratio scale 1:238
or otherwise)shall keep it in confidence and Divide second number by 12 to convert ratio to feet.Example 1:1200 is V=100'
shall not furnish or disclose o to any third party without Information shown is not guaranteed and Yankee Gas assumes no responsibility. ra aem ,,
the prior written permission of Yankee Gas. Contractors are urged to call Yankee Gas for further information at 1-8 0-989-0900 [Date, m The
SNor t Ste.,stlio Utilities System
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+ems 1 T .75"ST I P 1959
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46
623
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45.5'
75"ST IP 1959 21.5
The material contained on this map shall be considered TITLE: plot—menu—field 1
proprietary to Yankee Gas and user(which e lot fnenu_tleld 2
defined as any person or entity who has received p
the map through sale,purchase,exchange,gift, Ratio scale 1:238 c u or otherwise)shall keep it in confidence and Divide second number by 12 to convert ratio to feet.Example 1:1200 is V=100'
shall not furnish or disclose it to any third party without
the prior written permission of Yankee Gas. Information shown is not guaranteed and Yankee Gas assumes no responsibility. ra aem The Northeast Uttiiies Sysiem
Contractors are urged to call Yankee Gas for further information at 1-800-989 0900 a e 107 Selden St.,Berlin CT 06037
APPLICATION FOR STREET EXCAVATION PERMIT �p�L7d
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINbSOR,CT 06074
FEE $25.00
Name of Firm 1 ) 1< k l- &� y �' �/q�-'-�"���Address of Fir Phone No
2 �c) cS �f'
Location of proposed work el A-) A.,
Describe fully nature of permit requestedxC ,�u
G ✓d L "-A � n1 F/A
Starting date e(-, 3 /
Approx.time for completion 4-7t? - Tj
Call Before You Dig No."_ 0 D7 13 0 3 0( Traffic Services Control No.
Show sketch of proposed work or famish
two copies of separate drawing Indicate North This section to be filled out by
Town of South'Windsor
Pavement Cut
No.cuts
Est'Size of Penn.Patch(s)
Est.Pvt.Thickness in.
Est.Unit Price$
Amt.of $
Total Due$ by
( )Cash )Check#
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
ArnL Due Town
By
Applicant is responsible for contactina
the Police Dept.and C.B.Y.D. Date
1 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 ASIDE BY THE RULES AND REGULATIONS FOR
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed:_ 1-1-0
� Date:_ , �� -
Driver's License M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
,//°
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