HomeMy WebLinkAboutGas Street Cut Permits 91 Pine Knob Driv (2) vtv-
TOWN OF _SOUTH WINDSOR INSPECTION REPORT
Permit No. 2933 t Contractor YANKEE GAS
Location 0091 PINE KNOB DRIVE " Address 112 PROSPECT HILL Rid
Type Work GAS E . WINDSOR CT ObO88
Phone. No. ( 860 )292-2242
Date Insp Needed _ _ -- - Date Insp.
Time Insp Needed __._--- � .'_ � Time Insp
Inspected By
Work in Progress --
r r3 pu t __ bate
Permit No. 29: 3 sown cif South w i nascw , re v
Gate 0 3r24/20k i[' tr'eet. Lxcavat.,on Permit,
Expiration Date 03/214/2001
Descrip: REPAIR GAS LEAK
Applicant ;_ocat i pn
1
Name YANKEE GAS 00,91 PINE ,KNOB ?RIVE �
Add r. 112 PROSPECT HILL RU
E . WINDSOR CT 06088 T ype of, Work GAS
Phone ( 860 )292-2242
Applicant agrees to furn i sh the Town of South Windsor the amount of band
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 applicant is fa+nr l .rar with and will abide by the rules and
regulations for permits as rutyl i ned in the Town of South Windsor ' s Street
Cut Permit Manual .
PERMIT TO Br= KEP_T,. .ON JOB ,'SITE AT ALL. TIMES. �
Issued by f
T i t l'e ,
Date tromp 1 et.ea - -- - ---- --_ ---- Inspected . By
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 (aS Phone No.
Address of Firm I ( off- (03 C7t- fl (
Location of proposed work t reef }- # i/Ik roc'b
Describe fully nature of permit requested 12 S Ito
Starting date a Approx.time for completion
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 Prop.size of cut
n` No. cuts
Amt. of Deposit $ by
O Cash O Check M
Cut size after Perm. Patch
No.Cuts
Final Billing S
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 R€MBURSE 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: L O C)
Title: h D.L.B
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES