HomeMy WebLinkAboutGas Street Cut Permits 14 Stone Crossing TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No _ Cont..;V CtOr YANKEE GAS„
Location
_ Add 112 „P?i2OSPECT $ILL RD
Type Work GAS .. DSOH*.CT. 06Q.88
Phone No ;;f Sp 2$'2 22r4:2
Date Insp Needed Da Insp:
Time Insp Needed -----� x me In /►
----- - -
f. s.
Inspected BY
Work in Progress
is
........:.:..:.:::::.:..
Inp'"iC £3'ate
Permit No. 4282 Town of South Windsor, CT
Date 08/31/2006 Street Excavation Permit
Expiration Date 08/31/2007
Descrip: INSTALL GAS SERVIOt
Applicant LocatGn
Name YANKEE GAS 0�#i4,.STONE CS7S:S.SIG
Addr. 112 PROSPECT HILL ,Ah "
E. WINDSOR CT 0`60B$ fie..
Phone (860)292-2242 '
A PP g licant a reel: to-fUTn.a s: 'the �csW s<'s; f;::.ao :t Windsor" `.tal e{;;,atndunt of bond
required and to rei rse:'t1�e :ToGz i 'c moUr fiir';aiiy.e 3cpenses
y..:;,;;
incurred by the Tow11. .a' R}alzYtnance or' repair tacirk;:>=axa! :ciincti;on with this
permit and that applIcanE xs 4[i73a " xz �+x'11 ab 'd by the rules and
regulations for permits as 61ztline f S0-Ut'h W�, :d:sor's Street
Cut Permit Manual.
* * PERMIT TO'::BE K�P,T eTOB S�.:TE AT„ATr7u,,.TTMLS.
'sueIssued by •.: ; ... >:, ,..,:: ::> .:: .
Date Completed Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR a C
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm �, `
Address of Firm ,. Phone No.,," 62 — �9 2—
Location of proposed work cS �� 2 ` Z - 17
.Describe fully nature of permit requested
� -
s�
Starting date
Call Before You Dig No. 3 Approx. time for completion
6 2 Traffic time
Control No,
Show sketch of proposed work or fumish
two copies of separate drawing
Indicate North This section to be filled out b
Town of South'Windsor
Pavement Cut
> No.cuts
Est.Size of Penn.Patch(s)
Est.Pvt.Thickness
v
Est.Unit Price$
Amt.of Deposit$
5 Total Due$
by
( )Cash( )Check#
Permanent Patch
L No. Cuts
Size of Patch(s)
_ c
Final Billing
W D $
/1 Amt.Due Payee
A $
• C. C. Amt.Due Town
Applicant is res onsible for contactin By
the Police De t.and C.B.Y.D.
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE
CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND W TOWN ILL AB DEND REQUIRED AND TO REIMBURSE THE
PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT pERM1OR MAINTENANCE OR REPAIR WORK IN
BY THE RULES AND REGULATIONS FOR
Signed: � T MANUAL.
Title: L. (� Date:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Driver's License#:
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