HomeMy WebLinkAboutStreet Cut Permit 44 Newmarker Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 4162 Cont°Yaq.t,_or'V'YNKE__ A>5.,
Location 44 NEWMARKER ROAD gg
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Type Work GAS `:.: -,< DSf➢•1 05-.088
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Date Insp Needed
„imgTime Insp Needed wS;` .: =4
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Inspected BY `r:sapl
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Permit No. 4162 Town of South Windsor, CT
Date 03/23/2006 Street Excavation Permit
Expiration / / rr.Y%.fr- y. y
Date 03 23 2007 "<•.
Descrip: INSTALL GAS SERVIC&<"PO<,::InT3S: t .
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Applicant xs - `n40 r
Lac-aE:ion
Name YANKEE GAS
Addr. 112 PR
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E. WINDSOR CTEs::•.$ k
Phone 860 29
Applicant agreds.''a T-Ui
Ebtsm the . #2 ' � ' �> '€ h :<'
; <; 6#� 4d 'YiS7 ' he a punt of bond
required and to rimb r °I
req u< �.�.;Y>.�'�� ��wn.:.<.a�,,.fib,; h,�,.� n a P;enses
incurred by the Toa ' ;ors'm ;xt:e`xi'n ' :< :e , wcz}c'_ i ,°ccnri' t}on with this
permit and that applicant f .s:'„ a�li K: i `.. fit' >'wi� ISd by"t}ie rules and
regulations for perfnitiS>?<a��::.•.o.utlne , y oo°[{t.} W. ndfior s Street
Cut Permit Manual. `<
PERMIT> >.jC P��yON'��:7G+�> 'T:PE;'A;Tx:�•tiI,{, T��IHE.S'.��
Issued b
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Date Completed _--_—_-- TY'spected By -
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APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR Permit No.
` PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00 pp
Name of Firm ld h S Phone No. 8 6c-— d2
Address of Firm 11 2 P R,G d' #0,4- cy ' Id/ // r—S�) y G),
Location of proposed work 27- q A) W A40 4 1-r, Kb A) Y�,\)-ON
Describe fully nature of permit requested 1X J�K,tr,n7 j AI
Starting date 3'--2,7-- D L _ Approx. time for completion lz�) 10.Kcr
Call Before You Dig No. `�-�o (O ! b YES Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
Est.Size of Perm.Patch(s)
Q Est. Pvt.Thickness in.
Est. Unit Price$
Amt.of Deposit$
J
Total Due$ by
3 ( )Cash( )Check#
es a
� Permanent Patch
No. Cuts
(Lt
Size of Patch(s)
w 0 tr Final Billing
✓ �_ Amt.Due Payee
Amt. Due Town
Ljonsible
BApplicant is for contacting Date
the Police De t.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:ep. --se— �� r.��--� Date: 3 2— 3
Title:_ 7--/ "2-T _dam CT� Driver's License#: _
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
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