HomeMy WebLinkAboutStreet Cut Permit 00 Pine Knob Drive 900163 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE:. 12/07/09
GIS ID:99997200 s ""
s � FEE: .00
MOMS APPLICATION# 200901481 may, IRATION DATE:
y�
"
APPLICAN "
LOCATION
NAME: YANKEE GAS DRIVE AND AVERY
ADDRESS: 112 PROSPECT HILLz %yam -X� SOUTH WINDSOR
EAST WINDSOR,CT. 68
2 / : �� IIL IVAN AVE
R,CT 060742734
PHONE. 860-292-2242 3/
Svow
WORK DESCRIPTION: EXCAVAff
SEET�TE
APPLICANT-AGREES TO FURNISH THE TC0FQIT15
THE TOWN OF SOUTH WINDSOR FOR ANY X-R 0 tC �' �SQUIRED AND TO REIMBURSE
CONNECTION WITH THIS PERMIT AND THE_�Pft ITFI 013 4IAINTENANCE OR REPAIR WORK IN
� NISL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED INTHE TOWN OF S� TTLVIDSRSTRIU1 ITMANUAL.
l� 01 0 ,;
ISSUED BY DATE INSP/ TED INSPECTED BY
12/7/2009.9:32AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
-fill ffi
iy /mc
la
Ah
7-1 fffflav
-----
AA -
�� �
�� i�
u. -07
-.y
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: ct Oo 1(o : CONTRACTOR: Yin n Yee-,
LOCATION: Ayeru a-
TYPE OF WORK: cfma gal AnIPc j) Par+ O� UG ✓�
DATE INSP NEEDED: DATE INSP: Z/d
INSPECTED BY: BD
WORK IN
PROGRESS: C'br l rye na rn ��j w d S i'tc/` Cj]
fi Lf"l✓- S'PC/+LID✓l SAS i✓ia,`yR� OKk '2 xygA
X r -G Scco-a V gi
'Et OA
G
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: CA- DATE
W/2007 Town of South Windsor INPSECTION REPORT 07
T APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSORf CT
FEE $25.00
Name of Firm
Phone No.
Address of Firm II Z IQO LC�
Location of proposed work iN E WEE 8 WE
Describe fully nature of permit requested C 20-7,47
Starting date /Z-7-d Approx-time for completion
Call Before You Dig No. Traffic Services Control l40.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavement.5i
Indicate North Prop.size of cut X-
No.outs --
"Amt.of Deposit$ by
cash()Check#
lit Cut size after Perm. Patch
No. Cuts
Final Billing t
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 SO ^5 STREET CUT PERMIT MANUAL -
Sign Date: �� I
Title: D.L#•
PERMIT SHALL BE KEPT ON 3013SITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permitdoc
Molloy, Catherine
From: CaliCenter@CBYD2.com
Posted At: Thursday, December 31, 2009 1:03 PM
Conversation: Locate Request-20100101145
Posted To: CBYD
Subject: Locate Request-20100101145
(CALL BEFORE YOU DIG - CT) 12/31/2009 13:02:31
-5G -C1 -CW -GV
-OT 1-SW SWINDS -T5
--------------------------------------------------------------------------
*** REMOTE BATCH ENTRY ***
***** ROUTINE *****
TIME. .13:02 DATE. .12/31/2009
REQUEST NO. . .20100101145 PREVIOUS REQUEST NO. .20094902386
LATITUDE. .41.8336492 LONGITUDE. .-72.5113068
TOWN. . . . . .SOUTH WINDSOR
STREET. . . .PINE KNOB DR
NEAREST
CROSS STREET. .AVERY ST
--------------------------------------------------------------------------
TYPE OF WORK. . . . .EXC TO WORK ON GAS MAIN
AREA IS MARKED. . .YES
REMARKS:
EXC IN TWO LOCATIONS TO WORK ON GAS MAIN WORKING IN INTERSECTION AND 150' UP PINE KNOB
PLEASE MARK ENTIRE INTERSECTION
--------------------------------------------------------------------------
START DATE. . . . . .01/06/2010 START TIME. .08:00
CALLER. . . . . . . . . .MATT MARTEL
CALL BACK. . . . . . .7:30-4
PHONE #. . . . . . . . .860-292-2208
FAX #. . . . . . . . . . .860-292-2269
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .YANKEE GAS SERVICE CO.
ADDRESS. . . . . . . . .112 PROSPECT HILL RD
CITY. . . . . . . . . . . .EAST WINDSOR
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06088
--------------------------------------------------------------------------
EXCAVATOR DOING WORK. .YANKEE GAS
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED:
1
i
1
f
1
j
1r � II
� N
44 ;�
C..�;
z
0
0
57
CD
CD
Ln
II Ov
N
! it
N
W
J
U2
The material contained on this map Tine:
shall be considered proprietary to
Yankee Gas and user (which is
defined as any person or entity t4
who has received the ma through Information shown is not guaranteed and Yankee Gas
Pa c
sale, purchase, exchange, gift, or assumes no res onsibilit 9 Contractors are urged to call "r
otherwise) shall keep it in confidence Yankee Gas for further information at 1-800 989-0900
and shall not furnish or disclose it
to any third party without the prior The Northe' st Utilities System
written permission of Yankee Gas. Plotted: 03—Dec-20o9 By: martemd 107 Selden St , Berlin CT'06037
1