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HomeMy WebLinkAboutDrain Layers Permit oo Avery Street 900046 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 05/08/09 GIS ID: 06309999 ✓ Y .a FEE: 00 MUNIS APPLICATION# 200900464 3 ` t ,k; .� �.F. pIRATION DATE: APPLICAN . �f spy N „� LOCATION NAME: YANKEE GAS RES�r iRY TREET ADDRESS: 112 PROSPECT HILIIt ' s s ' � TWll SOUTH WINDSOR EAST WINDSOR,C & s �4 $UL41VAN AVE �AL.- SOR'CT 06074 PHONE 860-292-2242 WORK DESCRIPTION: TESP Y,At APPLICANT AGREES TO FURNISH THE ta0UT1 AMO : t .1 HBO REQUIRED THE TOWN OF SOUTH WINDSOR FOR Al`lty 1 ¢ Q D AND TO REIMBURSE CONNECTION WITH THIS PERMIT AND TA S��. w � Q '. INTENANCE OR REPAIR WORK IN - ,. k`t I M VI ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN TOWN O 0 � 3R' E*T MANUAL. I3 ? } /«3 ,rye ZZ ISSU D BY DAT PECTED INSPECTED BY 5/8/20094:21PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: 7000 CONTRACTOR: LOCATION: TYPE OF WORK: tS DATE INSP NEEDED: DATE INSP: INSPECTED BY: WORK IN PROGRESS:_ G�-f Co, Tod T©SLO AS-BUILT: INPUT: �^- DATE:_ 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 $25.00 Name of Firm Y-n des 292-22t9 Address of Firm t12 ( - H.1I Phone No. Location of proposed work Describe fully nature of permit requested T51- F[o4s- d lLlo��e , ih. Starting date t3 Call Before You Dig No. Approx.time for completio 009 Traffic Services Control No. Show sketch of proposed Hrorlc or famish two copies of separate drawing Indicate North This section to be filled out b Town of South'Wi 'dsor Pavement Cut E(79 # No.cuts EsL•Size of Perm.Patch(s) f ExiSr �,qs TEsr H MAIN IQ OKI ( m►IN�rrsdD) EsL Pvt.Thickness in. t I Est.Unit Price$ E . EXIST. I s r+er✓�T 6A3 MAW Amt.of Deposit$ k Total Due$ by t j Cash( )Check# 1 . ip GA6 N041 i �}�iae Permanent Patch � � Rt'1C7GAn LAN, ''GtC GA-S MAtN • No. Cuts i EtKH CA;rC* t3AUN Size of Patch(s) Final Billing Amt.Due Payee Amt.Due Town By Applican is responsible for contacti the Police De t.and C.B.Y.D. 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 THI§A2FRMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS. I E I E TOWN SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date:_ 5�b/104 Title:_- Driver's License M PERMIT SHALL BE KEPT ON JOBSITE.AT ALL TIMES W--4 C Ord&r. SE-%022 B ADV7&