HomeMy WebLinkAboutGas Street Cut Permits 357 Pleasant Vall Permit No. 2409 Town of South vdindsor, CT
Date 04/02/1998 Street Excavation Permit
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Expiration Date 04/02/ 1990
Descrip: REENERGISE GAS MAIN
Applicant Location
Name YANK;EE GAS 0 3 5'7, PLEASANT VALLEY
Addr . P.O. BOX 1030
MERIDEN CT 0fi450 Type of Work GAS
Phone (800 )989-0900
Applicant agrees to f u rn i ah: thee� Tovvh Of S6kuth W'�ndsor the amount of bond
requ i red and to re i mbur.se 'the" Town of''South Wintls.or far any expenses
incurred by the Town for maintenance .or repair wo'ri; in' connection with this
permit and that applicant is ,familiar" with IAnd: w4,11 abide by the rules and
regulations for permits as odtlined in the ToWn of South Windsor ' s Street
Cut Permit Manual .
`.PERMIT TO BE KEPI` ON JOB SITE AT ALL TIMES .
0, -�- , .
Issued by
Inspected By
Date Compl!et�ed _5�_, __._ _--
APPLICATION FOR STREET EXCADSOR N PERMIT
PUBLIC WORKS DEPARTMENT
TOWN HALL -
1540 SULLIVAN AVEN,IU,E
SOUTH WI DSOR,
Name of Firm Aq-Q- IL C d �t=25 Phone No. 9� -',Z ZJr 7
Address of Firm i T el
Location of proposed work s �Z
Describe fully nature of permit requested C- E
Starting date Approx.time for completion X
Call before you dig no. 9 8 12.-o t S Z m Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Tomm of So. Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.sue of cut
No.cuts
workwraa
Amt.of Deposit 6 by
/1 O Cash O Check N
F753 d Cut size after Perm. Patch
No.Cuts
VA Ov- 'Z 7 Final Billing$
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 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:
Title: -/..L Id 'et/) q l" I ee / D.L.#I
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES ------ _--__-- ---—-___- _--