HomeMy WebLinkAboutGas Street Cut Permits 107 Pine Knob Dri TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No . 2932 Contractor YANKEE GAS
Location 0107 PINE KNOB DRIVE Address 112 PROSPECT HILL RD
Type Work GAS E. WINDSOR CT 06088
Phone No. (860 )292-2242
Date Tnsp Needed Date Insp._
Time Insp Needed -_ -- Ti
and Insp.
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Inspected By _
Work in Progress
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Permit No. 2932 Town of South Windsor, CT-
Date 03/24/2000 Street ExcavaLion Fermat
Expiration Date 03/24/2001
Descrip: REPAIR GAS LFAh..
Applicant Location
I
Name YANKEE GAS 0107 PINE KNOB DRIVE
Addr. 112 PROSPECT HILL RD
E . WINDSOR CT 06088 'Type of Work GAS
Phone ( 860 )292-2242
Applicant agrees to furnish the Town>of South Windsor- the amount of band
required and to reimburse the ITown ,of South Windsor for any expenses
incurred by the Town for ,maintenance or repair work in connection with this
permit and that applicant is familiar with and Will abide by the rules and
regulations far permrts as out lined' in the Town of South Windsor- ' : Street
('ut Permit Manual .
PERMIT TO, BE KEPT ON JUB SITE AT ALL TIMES. �
Issued by Title
Date Completed Inspected By
ati�a
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 10,vx Gwo Phone No. (�!&C) aci al--ta
Address of Firm vrb t
Location of proposed wor (Di2eM 0 10-) i ,-- hub 2
Describe fully nature of permit requested r 6-5 K..
Starting date $ CRE, Approx.time for completion
Call Before You Dig N O 00 a Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate draw g
C)rl Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size after Perm. Patch
_ — No. Cuts
r 1 of-1�ir,/ o to -0R Final Billing$
Amt,. Due Payee$
Amt. Due Town$
Applicant 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: Date: oZ C�
Title• C� Oil D.L.#•
PERMIT SHALL BE KEPT ON 30BSITE AT ALL TIMES
71 Standard_Forms\Permits\Street Excavation Permit.doc