HomeMy WebLinkAboutGas Street Cut Permits 30 Windshire Driv Permit. No. 2864 '
Date 09/ 17/1999 Town of South Windsor, CT
Expiration pate 09/16/2000 Street Excavation Permit
Descrip: INSTALL GAS SERVICE TO NEW HOUSE
Applicant
Name YANKEE GAS Location
Addr. 112 PROSPECT HILL RD O030 WI14DSHIRE DRIVE
E. WINDSOR CT 06088 `
Phone (860 292-2242 Type, of Work, G,,�S
Applicant agrees to furnish the Town of ,South Windsor the amount of bond
p
required and to reimburse the Town of South Windsor for any expenses
incurred by the Town for maintenance or repair work in connection
nses
permit and that applicant j with regulations for permits as, sfamiliar with and will abide by the rules and
outlined in the Town of South Windsor 's Street
Cut Permit Manua ,
�` * ,PERMIT T0 I
KEPT ON JOB
.SITE AT ALL TTMES.
Issued by
Date Comp l e ted -_--
Inspected By --
Aug
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm Q0 L¢-, �7 as Phone No.
Address of Firm D- C+ H 17.Q
Location of proposed work 36 W i al 5 h,rC.,
Describe fully nature of permit requested W1Sto-kk QCZ S S2(V�c�_ ,new ho w
Starting date D 99 Approx.time for completion 3'c)o PM
Call before you dig no. /9 9 93$C7 Traffic Services Control No.
Show sketch of proposed work or furnish TO be filled Out by To Of So wlndSOC
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
/�► Amt.of Deposit S by
O Cash(1 Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
WINDSHIRE
4"sry Amt. Due Payee S
S 1-bEw qL-K 3 x5 61i Ore-a-
Amt. Due Town 8
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 RQ1MBURSE 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: Qkk� Date: 9 9
Title: ^.�� �uCk . D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES