HomeMy WebLinkAboutGas Street Cut Permits 37 Steep Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No, 3719
Location Contra^ tor Y
P AD ANKEE'CAS
Type Work GAS Address 112 pRpSPECT:;,HILL RD
WIkbsoR CT 06088
„Rhozle No ($fsQ)292 :"2242
Date Insp Needed
Time Insp Needed
Inspected By
Work in Progress 1— ^-
Input
Date
Permit No. 3719 Town of South Windsor, CT
Date 05/27/2004 Street Excavation Permit
Expiration Date 05/27/2005
Descrip: REPLACE GAS SERVICE TO" HOUSPR
Applicant " LocC:ion
Name YANKEE GAS p'' 7 8 -EE:P ROAD
Addr. 112 PROSPECT HILL RD
E. WINDSOR CT 06088 Typef;,;Wor: GAS
Phone (860)292-2242
Applicant agrees ta;;furtsh the ":Town o �cuh Winscxr.tke aanoznt of bond
required and to rejmburse the,: Town of $ou;th y7 ridsor flor any ,ex e ses
incurred by the Town ;fotr aixtCenazt :L or 'repaar .:work 3, gbnnection with this
permit and that applicant , 'familiar with ana: :w 11 'b de.'b,y the rules and
regulations for permits<<as ou,tlioet: azs. t1�;e. Trstan? o South 'Windsor s Street
Cut Permit Manual.
* * PERMIT "FO BF;:..KEPT ON w10 AT ALL „TIMES,,,'*
^ '
Issued by �{/r Title
Date Completed Lx. ,pe:et'e'd By _ A- aaI/r✓ U
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Phone No. 1A-(;0A -7
Address of Firm Lr ILI `
Location of pro osed work V ipv5 �� _
1wIlA�1� v V -SkMC 51 lr Or✓ �c111�1MF, �! •v�CQ
Describe fully nature of permit requested R '' STceL S w IlaR� t►
Starting date 44 t Approx time for comp) } ,
Call Before You Dig No. ' ' --"" """for "'r��u�
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawingAme' isriNG 314 To be filled out by Town of South Windsor
Ml SORVIO
Pavement C
Indicate NorthEWProp. size of cut
' No.cuts
Amt.of Deposit$ by
Rao ()Cash()Check#
3-7 ST & R60 Cut size after Perm. Patch
'11 �rf EP Ro ia� No. Cuts
19 STEEP UAW/ �
110 14I 1-0)bE DRIVE' Final Billing$
13 5TER FohDI/ Amt. Due Payee$
934 FosT r R 5T. Exr Amt. Due Town$
Applicant is responsible for contacting
the Police De t. 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:_ �r/�7
Title ✓�.. l� c1�e 7�7c�
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc