HomeMy WebLinkAboutGas Street Cut Permits 105 Wentworth Dri r' •' TOWN OF SOUTH WINDSOR INSPECTION REPORT
Location 3243
0105 WENTWORTH ORIVE Contractor YANKEE GAS
Type Work GAS Address 112 PROSPECT HILL RD
E• WINDSOR CT 06088
Phone No. (860 )292-2242
Date Insp Needed 3e-
Time Ins dat
p Needed e Insp. /i3�a2
"I me Insp.Inspected By
Work in Progress
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Perr,,i t:/rv.o -�I 3243 Town of South Windsor, CT
Date 01 /28/2002 Street Excavation Permit
Expiration pate 01/28/2003
Descrip: INSTALL GAS SERVICE TO HOUSE
Applicant Location
Name YANKEE GAS 0105 WENTWORTH DRIVE
Addr. 112 PROSPECT HILL RD '
E. WINDSOR CT 06088� 1 . ' ,Type of- Wbr�k GAS
Phone (860 )292-2242
Applicant agrees to fur"r►ish the own 6,f �$b.uth Windsor the amount of bond
required and to reimburse he',Towr o "Sout,h ;din°door for any expenses
incurred by the Town for" m4 j r7,enanc;e o+': 'repair ,Work i n connection with this
permit and that applicant i's f aml,l�"i'a,r with and wi 1 1 abide by the rules and
regulations for permits ,-,as -+gut l i rye i i n tf�® 'Town of South Windsor' s Street
Cut Permit Manual .
* * PERMIT TO .BE KEPT 'ON JO6 SITE AT ALL TIMES.
Issued by � ���Jl� Tulle �,y - ^-t��.��� �
Date Completed Inspected By __�
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSORf CT
FEE $25.00
Name of Firm /i Phone No. 6 D ^ 9, ` ri
Address of Firm 0 j Jr. W e
Location of proposed work N Q R, „•
De cribe fully n ture of ermit requested
KKK s. ��a 6< -� c a�c 4%,.Pr�
Starting date ® O Approx.time for completion 2-.�—
Call Before You Dig No. O Traffic Services control No.
Show ske or furnish To be filled out by Town of South Windsor
two copi of separate drawl
Pavement Cut
ndicate North Prop.size of cut
� 'D
No.cuts
Amt.of Deposit$ by
O Cash O Check#
Cut size.after Perm. Patch
C.'
off P� No. Cuts
G .L..• Final Billing$
Amt. Due Payee$
Amt. Due Town$
Applicant is responsible for contacting by date
the Police Dept.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: ��- Date: _l— �-✓ram' 20a�
Title• �) L �.�'C� D.L.#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permitdor