HomeMy WebLinkAboutGas Street Cut Permits 65 Sharon Drive Permit No. 2520 Town of South Windsor, CT
Date 12/21/1998 Street Excavation Permit
Expiration Date 12/21/1999
Descrip: REPAIR GAS LEAK AT URB BOX
Applicant . Location
Name YANKEE GAS (9C 05 4 SI AROK DRIVE
Addr. P.O. BOX 1030 �
MERIDEN CT 06450GAS
Phone (800)989-0900
S r' .r s a"i ' t
Applicant agrees to 'u ,' the � 7yideor the amount of bond
required and to reimbur` j4th 1 ` t f Or any expenses
incurred by the Town fcr m enanneC� ~ �pai �� gn; connection with this
permit and that applicant ���1 ands�� 1 0ide by the rules and
72
regulations for permits as girl ���� �a�� ,���� p�' � th Windsor's Street
Cut Permit Manual
( PERMIT TO 1� L TIMES.
Issued by
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Date Comp 1 e�,e.J Inspected By
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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 n u l-7 Q S Phone No. C�Ll
Address of Firm 4 c rQSnP r+ H7 1 1 -Pri.
Location of proposed work ID 5 �S h Q f p n (�f
Describe fully nature of permit requested c'x c c v - to r e-p C, 0 S Ile 0 k 0,4- C L, r ID b G X
Starting date /91,:;)3 199 Approx.time for completion hr ,
Call before you dig no. 1 q qg5 lc>1 R i-4 3 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 ►I"
5 No. cuts
J Amt.of Deposit $ by
('i QfC'CL O Cash O Check#
Cut size after Perm. Patch
� I I
S1 e.jczXy- Z No.Cuts
Final Billing $
Sharon fir.
Amt. Due Payee $
Applicant is responsible for contacting Amt. Due Town $
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:Aawu.� Lv v� Date:
� � ^rr la Idl9 �
Title: 31 C� (k yt,, D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES