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HomeMy WebLinkAboutGas Street Cut Permits 525 Rye Street Permit No. 2275 Date 02/70/ 19a7 Town of South Windsor-, CT Street Excavation Permit Exp i nati on Date 02l 1 r�! � �i55 Descrip; Applicant Name YANKEE GAS Location Addr. P.C . 80x 339 0625' R 'E STREET E14FIELD CT 06082 " Phone (860.)292-2226 Type. of -W 0 riN CAS Applicant agrees to furnish the rowri off' South " required and to reimburse the; Town of ,th Outhsor for an incurred by the Town for Maintenance ' ©S`'Ut air W for the amount of bond Permit and that aY expenses applicant ig farm far, P WOrk .in' connection with this regulations for wth "and wT71 abide by the rules and permits i s 4u.tl i ned i n the T©wn of, south Windsor 's Street Cut Permit Manual . * * PERMIT TO BE KEPT" �3N •JuD SITE AT ALL TIMES. x Issued by T i t l Date Completed ----_._-_------ Inspected By ✓ �"V',6o n ,C�'—. 4 APPLICATION FOR STREET EXCAVATION PERMIT BLCSOSEARDEPUI WORKD DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm / E',c 6="g S Phone No. e GO a2 }-2 • -'2 2-s—2 Address of Firm //2, -P/2.C�5 Location of proposed work .2 i S F ;;7 S �✓�/�9 JSro2 S; S 5/ �, S S' Sf' Pry„"%r Describe fully nature of permit requested / C-E-�;e •4-2'�F 49 O�c 0 Starting date YY!/'q- X /9-P 2 Approx.time for completion Call before you dig no. Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of So. Windsor two copies of separate drawing Pavement Cut Indicate North Prop.size of cut 7-//P/G,4 L x iv S,E'R T /v= w s'e e v ec 7-151f/Lo V c.-/?' O 4.'.9 No.cuts HO" Amt.of Deposit 8 by O Cash O Check# I� Cut size after Perm. Patch �i INo.Cuts Final Billing 8 Amt. Due Payee 8 Amt. Due Town$ 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 1 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: "/O Title: Y�/�GO D.L.# PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES