HomeMy WebLinkAboutGas Street Cut Permits Summerwood Lane r► ,
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3598
Location SUMMERWOOD LANE Contractor YANK8'8 GAS
Type Work GAS Address ji 112 P.RpS.pg(jT;,HILL RD
S WINbSOR`'CT 06.088
Phoia. No f'$ i7)292 2242
Date Insp Needed
--------- Date"'Insp
Time Ins c� —
p Needed
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Inspected By '. a7,14
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Work in Progress
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Input.,
Date
Permit No. 3598 Town of South Windsor, CT
Date 09/25/2003 Street Excavation Permit
Expiration Date 09/24/2004
Descrip: EXTEND GAS MAIN T0?''DEVEhOPM'$TT.
Applicant
L0 ati6n
Name YANKEE GAS STMMERWOOD LANE
Addr. 112 PROSPECT HILL Rp
E. WINDSOR CT O6O$8 Tyje 0 i�br]c CaAS`
Phone (860)292-2242
Applicant agrees to ftirni h'the rs Tow:., of SOUtk� Windsor the ,amount of bond
required and to reimbueTown b0uth"'Wxdsox for':'"any =eacpnses
incurred by the Towli. fGr m.aXntepance or repair wor nect.::i.p with this
permit and that applicant #saFnil�a `with aid w�21 ab 'C1e .by the rules and
regulations for permits as, out .inedxi,. theI. Town 'of Sputih W3ndor's Street
Cut Permit Manual.
* * PERMIT TO :BE KEPT ON'30g S.I:3E AT-ALL TIMES.
* *
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Issued by ------�------- --- Tit 1 e ��j Ei✓�i�
Date Completed °
_________________ Inspected B
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1S40 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm_ AkKte- hM 5 Phone No. a9o1- a�o5
Address of Firm_ I 1'Ro. v _GY H I Lt RoM1>
Location of proposed work S H A7F.,N n R,v t
Describe fully nature of permit requested ► N Srk)Li M M MI ff ro IY E w b lV EIofM, o i
(✓ fl 1VL' CteLLFD M -0D L v r
Starting date a cr6 I i`K a ao 3 S Appmpr,time for compietion Cu av> M a GR a oo
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing 5
Indicate North P Ro 1'e�5�D G—A'S �
X Prop.sine of out
I, S No.cuts
�V A t
deI Amt.of Deposit$ by
IV EW D wwr M! r ()Cash()Check
Cut sae after Perm. Patch
C No. Cuts
y
Final Billing$
Mlri� Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting date
the Police De .and C.B.Y.D.
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: Lt Jpnu ,. Date: I�r� 5&3
Title: T')fLn EMG l(✓LsL'P.
D.L#:
PERMIT SHALL BE KEPT ON 308SITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permitdoc