HomeMy WebLinkAboutGas Street Cut Permits 14 Stee[ Rpad Permit No. 2328 Town of South Windsor, CT
Date 08/01 /1997 Street Excavation Permit
Expiration Date 08/01/1998
Descr i p: EXCAVATE 1 'X 1 ' V�ACUWM HOLE TO ,'BOND", SERVICE
Applicant
Applicant Location
Name YANKEE GAS 0,(314' STEEP ROAD
Addr. P.O. BOX 1030
MERIDEN CT 06450 YPe, cif MOr" GAS
Phone (800)989-0900
Applicant agrees to furhJsh'.`the. Tawn caf South Wi1�ds r the amount of bond
required and to reimburse the—lowwn of. Sitth W1 cicisr .for any expenses
incurred by the Town fob ma.f t enance or �repai r W�arrk` i,n' connection with this
11
permit and that appl icah S- faini41ar wi :ar1d 9'll. bride by the rules and
regulations for permits `as QgUtl road in 1rh2 7owrt. 1 South Windsor's Street
Cut Permit Manual .
* * PERMIT TO icE( T ON' JOB sIT.E AT ALL TIMES .
i
Issued by
Date Comp l ett'ed ' Inspected By —
r
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC TOWN DEPARTMENT
1540 SULLIVAN AVENUE ��
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm `)e-r\ ec- Ga� o v C S Phone No.
Address of Firm ! \ ? }�rG-,jY A e A- ",- \,
Location of proposed work f Lt
Describe\fully nature of permit requested_
Starting date ") f 29 J`7-7 Approx.time for completion J »cam ,-, 4-h
Call before you dig no. 9 -7 Z'-hP Z 8;Z,1 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
No.cuts
Amt. of Deposit $ by
( ) Cash ( ) Check#
Cut size after Perm. Patch
No. Cuts
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: 7 /'q A �
Title: , , L�C( �i )O ,� f� D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
LOT
is
I�
77+3
,gNoaE / RACK of CUR3
S1LCP RD.
g7Z `3C� Z ; Z 1 - c8Y7-)