HomeMy WebLinkAboutGas Street Cut Permits 5 Sunrise Lane Permit No. 2840 Town of South Windsor, CT
Date 08/25/1999 Street Excavation Permit
Expiration Date 08/2,4/2000
Descrip:
Applicant Location
Name YANKEE GAS 007U5 SUNRISE LANE
Addr. 112 PROSPECT HILL RD
E. WINDSOR CT 06088 Type of Work GAS
Phone (860 )292-2242
Applicant agrees to furnish 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 applicant is 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 .
* ,'PERMIT TO BE KEPT ON 'JOB SITE AT ALL TIMES.
Issued by - Tit1 /��cr�.
Date Compl4tedInspected By
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 S Phone No.
Address of Firm 1 t l 1
Location of proposed work
Describe fully nature of permit requested 1
Starting date C� Approx.time for completion
Call before you dig no. ►11,13`1 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled Out by To Of SO Windsor
copie of separate drawing Pavement Cut
Indica a North Prop.size of cut
V
No.cuts
Amt. of Deposit S by
O Cash O Check#t
1�
Cut size after Perm. Patch
No.Cuts
Co tr1S C1z75$7 nq Final Billing S
Amt.Due Payee S
6
Applicant is responsible for contacting Amt. Due Town
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 R€MBURSE 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 Uktt (' 64 9)J 1
Dater
Title: I%� ✓�(�lVl!!'i nn
D.L.M
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES