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HomeMy WebLinkAboutStreet Cut public utility 200 Sullivan A 900151 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY ls DATE: 11/13/09 w GIS ID: 87300200 � ,,_ MUNIS APPLICATION# 20090 13 94 _ FEE: 00 RATION DATE: APPLICANT NAME: YANKEE GAS g _ LVVAXN TION ADDRESS: 112 PROSPECT HILL �20 SULAVENUE EAST WINDSOR,CT• = S ,I.1 VAN AVENUE LLC -; =B 15 PHONE 860-292-2242 s _ A �WIDSOR HILL,CT 06028 WORK DESCRIPTION: ABA AS SERVICE APPLICANT AGREES TO FURNISH THE TO THE TOWN OF SOUTH WINDSOR FOR ANY FI AINTENANCE OR REPAIR WORK IN ND REQUIRED AND TO REIMBURSE CONNECTION WITH THIS PERMIT AND THE I� ��� - LL ABIDE FOR PERMITS AS OUTLINED IN THE TOWN OF S T IT MANUAL Y THE RULES AND REGULATIONS ISSUED BY DATE INS E T D INSPECTED BY 11/13/200911:23AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** -------------------_...._... ...... ... ----------------------------------- AN Bal , �� M7ip� l , TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 9©O I S-1 CONTRACTOR: ,'C1 n Lee LOCATION: 20 O N ln-V e TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS: Ina o, C� 4-6 Coo nee re AS \,; Fn! SefViCSZ, w41C, < L2 a pCS_ SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: Z. a W/2007 Town of South Windsor INPSECTION REPORT 07 APPLICATION FOR STREET EXCAVATION.PERMIT TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00 Name of Firm Phone No. Address.of Firm 112 I4v - 4- wI �T ohflr Location of proposed work Zoo �sj 1. Describe fully nature of permit requested r,d,n S+P.Pv22 ( n2w Sys �2�ftiJG� Starting date � i 116 j • Call Before You Dig No, y,*W3351-f Approx. time for completion IZ)3*,oq Traffic Services Control No. Show sketch of proposed work or fiaml two copies of separate drawl Indicate North This section to be filled out by .� Town of South'wndsor R�A'�� 5 t Pavement Cut ROAD L,rr' 1 No.cuts • GJ T Est.•Size of Penn.PatctKs) gct5r'.. C*115T Nr 1 6A5 PlAk tJ 1 Est 2"s'r I-lP Est.Pvt.Thickness in. Sewl Lc Est Unit 1 I g r E Price —. Amt.of Deposit$ 'PRoP Total Due$ by Pf�PL C�A'S �Npyse�f )Cash( )Check# f Z� Permanent Patch I. _ I✓y w4`? � No. Cuts Size of Paws) Final Bltling Amt.Due Payee Arne Due Town By. Applicant is re nsible for contacti gg the Poll ce Oe t.and C.B.Y.O. - 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 PERMIT$ OU I E N THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: sG Date:- I1�lolD9 Tittle: Driver's License#: PERMIT SHALL BE KEPT ON JOBSITE.AT ALL TIMES I I I I /• / •II• I 1• I, I ® I I I �eeeeleerieeeee!lee.®.eeee.eeeeee®ee eieee.■eoaeeee■e����eeeeieeeeeee.eeee ■ee:■eee�aeee��;ee��,��eeeseeeeee!!■!e! !lee:iee�aeeseeeeLee.■eei®eeeeeeee!!! acnels�e,aeeeee!!eelleni�eeeenee®!■ !leelel���■�reee�i!lees!!!��!®!!!®!■� AIMeeli�!!!!!UWE ONE !®s■®! so no ■!!!1■moll !!!!!!!!!!!!!!!!■ ■!!! iN!!!!!!!!!!■®!!!!!!!!!!!��■ aNeles!!!!!s■■e■■®!!!!!!!!e■ !®!!!!!! n!!!!!!!!!!!!!!e!!!!!!!!®!■ !®!!!®!!!!!!!!!®s®!e!!!e!!!■®!!e!!■ !!!!!e!!!!!!!■®!!!®!!�ON No ■!!!!®®eerie!!!!!!!! . !®!!!!!!!!!!!!! No !!!!!!!!!!!1�!lleell!■ no!!!! !!!!®!� !!!mom ON 0 mom ®!®e! !!!!!■!!!®!! mom !!!!!!!!s!!!!®!!®!ON ®!!�■ !!!!!!!!�e!!!!!!!!■®!!!!!!!!!!!a an !®®!! !l !!!!!�0 !!®!!�■ !!!lrr�■ !!!!!!!! e.r��r e!!!!!!!re!!!!!!!!!!!!!!!!!!!!le�r�r !!!!!!!!!!!!!s!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!IS -0e!