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HomeMy WebLinkAboutGas Street Cut Permits 8 Stanley Drive Permit No. 3022 Town of South Windsor, CT Date ' 08/29/2000 Street Excavation Permit Expiration Date 08/29/0001 Descrip: EXCAVATE T04REPAIR GAS LEAK BETWEEN STREET & SID-WALK Appli�6anf- Location Name YANKEE GAS 0008 STANLEY 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 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 applicant is familiar with and will abide oy the rules and regulations for permits as outlined in the Town of 'South Windsor 's Street Cut Permit Manual . * PEOMIT TO 8 KEPT ;ON JOB SITE AT ALL J,IMES. .%Issued by Title t.�e� r;:,.., �� _." Date Completed _ __�1 _ Inspected By _ 3aaa APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH-WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL - 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm t'I ICQA Q S Phone No. a-9 a--� a 4 a_Address of.Frm d, � GSA �nc�S Location of proposed work r _ i 0.r11P G n Describj full nature of permit requested tl S 1� c�tL u,P� •, c Starting dat 1411 x o © ApRrox.time for completion 1 a-14 Call Before You Dig No. oil Traffic,Services Control No. Show S. h of proposed work or furnish u o Tube fined t 6v T two copies of separate drawing Wn of ui�h Windsor Pavemer+t r„t Indicate Nort Prop.size of cut No.cuts Gj Amt.of Deposit$ by O Cash O Check# Cut size after Perm. Patch No. Cuts 3 xs. CU5 0.1rec- Final Billing$ Amt. Due Payee$ Amt. Due Town$ Applicant is responsible for contacting by the Police De t.and C.B.Y.D. date I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BONA REQUIRED AND`1 O REIMBURSE THE TOWN OF $OUTH WINDSOR FOR ANY EXPENSESINCUFRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS OERMIT 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. O Signed: S cZ8 �O y Date: Title:. D.L.#. PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES Standard.FormAPermits\Street Excavation Permit.doc.