HomeMy WebLinkAboutGas Street Cut Permits 220 Stsrong Road Permit No. 2499 Town of South .Windsor, CT
Date 10/02/1998 Street Excavation Permit
Expiration Date 10/02/1999
Descrip: GAS SERVICE
Applicant Location
Name YANKEE GAS 4g2C - TRC3> (j BROAD
Addr. P.O. BOX1030
MERIDEN CT 06450 Type 'tf ys'r�kGAS
Phone (800)989-0900
Applicant agrees to fu rn i:sh th a 1'ogn of South ,.Mi►adsor the amount of bond
required and to reimburse tk e, .Town of uth W nd .dr� for any expenses
incurred by the Town for ��;n maten4n:ce or pair work connection with this
permit and that applicant `€4jar l i a wh .,and w i T 1. abi de by the rules and
regulations for permits as otl ned., n ,the Tawr of .South Windsor's Street
Cut Permit Manual .
* * ERMIT T B KEPT ON ;,JflB 'SITE AT ALL TIMES.
Issued by .7ItI e
Date Complet dj Inspected By
APPLICATIONN FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL ����
1.540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm Qn��ar z S o Phone No.
Address of Firm2Z S�]
Location of proposed work
Describe fully nature of permit requested
ns
Starting date /� , \ f lqq Approx.time for completion 1Jo Call before you dig no. 9 R `1 t'T Traffic Services Contrd No.
Show sketch of proposed work or furnish To be filled out y Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North
Prop.size of cut
vj No.cuts
Amt.of Deposit S by
0
O Cash O Check N
Cut size after Perm. Patch
�t to'P�Zo� o1ctS
S¢ry<«O No.Cuts
�i co�oseo� wct�c o�c�v Final Billing$
Amt.Due Payee 3
SaC tOr1�Rd • Amt. Due Town 3
Applicant is responsible for contacting
the Police Dept. and C.S.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: a -
-~'�-� Date:
Title: t �� 9 /.en t 4e/ D.L.#t
PERMIT SHALL BE KEPT ON J08SITE AT ALL TIMES