HomeMy WebLinkAboutReplace cP test station Street Cut Permi 800019 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 03/14/08
GIS ID:72000022 . :%.: FEE: 00
MUNIS APPLICATION# 200800249 ;'->.. >` k`
';,E,. 'X 'I:RATIONDATE: 03/14/09
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APPLICANTf :,
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NAME: YANKEE GAS
0 OB DRIVE
ADDRESS: 112 PROSPECT HIL L RIB°:' ' RNNDFZ ALEJA
EAST WINDSOR, k ....
NDRO M&MARIA M
CT '&: ,:8 ,
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�.� E-KNOB DRIVE
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PHONE 860-292-2242 IxTD '
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WOR
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PLICANT AGREES TO FURNISH THE T(J1VI ; F QUTH:�?? MO (QF g'pN. REQUIRED AN
D ND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY ExPE.aaaySLS [T !_ X FOT;:MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APP�,IOAN• 'Iv:R R.W-1 Ti'AND SX Lk.'ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED
/j/INS THE TOWN OF 3��JT�T �D�R'�`±�l k�FT�tT. '��RI�I'T MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
3/14/200811:59AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: E bb0 19 CONTRACTOR: S
LOCATION:_ a P y
TYPE OF WORK:_DATE INSP INSP NEEDED: DATE INSP: S th$
INSPECTED BY: gD
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INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
PAGE 07/13
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TOWN. SOUTH WINDSOR - -
KEY AmEITYPE: IIPEACH IDR RECT WORK ORDER NO: 8E810081
TEST STA#: 18 ACTIVITY CODE. MMRiEP
C.S.Y.D.
DATE CALLED: 42/290J�2008882
PINE KNOB CIR(IN FRONT OF 022) START DATE: 0310&2018
REPLACE TEST SOX AT EOM
t 2"M11W IP 1959 0POLICE OFFICER NEEDED
0 PERMITS DONE
PERMllT&NEEDED
�.. MARKED OUT
R 0 STATE PERMIT SUBMITTED
DATE:
Et TECH PRESENT ,
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HNICIAN CONTACT'E DUMOND
60-2067
S42-�5164 PIN#3944
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SCHEMATIC UPDATE
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CLOSED
Iviv rV-K STREET EXCAVATION PERMIT 80---°O )9
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No. .
TOWN HALL
1540 SULLIVANAAVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
Name of Firm . ` 9
Address of Firm S phone No,_o2 63 5 (} ,9 6
Location of proposed work '
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Describe fully nature of permit requested
Starting dated
Call Before You Dig No._� Approx.timefor completion_ -,
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This section o be filled out bO
- Town of South Windsor
Pavement Cut
No:cuts
Est Size of Perm,Patcj(s)
�n r Est.PvL Thickness In.
(9 Est Unit Piece$
Amt.of Deposit$
Total Due S by
Cash( )Check#
Permanent Patch .
No. -Cuts
Size of PaUXs)
_--.-__--— Final Billing .
$
AmL Due Payee
Amt.Due Town
Applicant is responsible for contacting By
the Police De L and C.B.Y.D. 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.
Signe
Date:
Title: ,p"
Driver's License#:
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- .PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES