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HomeMy WebLinkAboutGas Street Cut Permits 79 Steep Road ol TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3721 Conti;.actor 'YAN EE::,.GAS Location Address 112 T?ROSPECT,. HILL RD Type Work GAS E. WTNb5OKiCT '0;.6088 phone:::: d$ ;0)252,y<2242.' Date Insp Needed __--_----- _ Date Lnsp ; Time Insp Needed Time Inspected By Work in Progress --------------------- r II3te t Permit No. 3721 Town of South Windsor, CT Date 05/27/2004 Street Excavation Permit Expiration Date 05/27/2005 Descrip: REPLACE GAS SERVICE TC"<HOU$F: Applicant Locat: Qn Name YANKEE GAS OM.7 Ft.9 STEEP ?AD Addr. 112 PROSPECT HILLRD E. WINDSOR CT 0608,9' Tre pi *�€zkA$ Phone (860)292-2242 Applicant agrees to .furnis. the :96ut'b Winder the amount of bond required and to reimbufse thc; Taiz*yi Q Sou-ti Wm- dSor for ariy nses incurred by the Town fob maxri;t nance 'br repai ''#crtk i.3 ecinnecti.an with this permit and that applacarit is tt532,a r rAt� h x�d; uri11 abide by tk'e rules and regulations for permits as but:llned'''In the TOuz of South inds'or's Street Cut Permit Manual. * * PERMIT TO j$E KEPT ON JQB BYTE A'T AT,4 TIM$'S. Issued by ---........ — Title Date Completed _—__ Inspected y ,! s APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm Phone No. q�'rt Address of Firm Gr }fit �,� �11)Vb� Location of proposed w,oArk iOvS s _ _ ®� MAZI f ©1A, SkML5 Si DE 6FF bc11L!lkc- n^111 MIT S EIRvIGQ Describe fully nature of permit requested R ht 75rpaet Starting date 111115 Approx time for completion ,,� , Call Before You Dig No. • � --- --..._.-. ,�,,,�,Y Traffic Services Control No. Show sketch of proposed work or furnish "IST14 314, To.be filled out by Town of south Windsor two copies of separate drawing H0146, sTmL sertvwt Indicate North �/�W `l� Pavement Cut - Prop. size of cut ter ; �.� No. cuts Amt. of Deposit$ by Roo ()Cash()Check# '2-7 STE 1' R60 Cut size after Perm. Patch 1 rEEP OW/ No. Cuts f 7>� 141 LINbE ,DAW Final Billing $ 1 13 STEEP F,np✓ Amt. Due Payee$ 9,34 T. EXT 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. G- Signed: 7 Date:_ Title: 1✓Y,. Gi�l�cj /7� a D.L.#: PERMIT SHALL BE KEPT ON 3OBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc