HomeMy WebLinkAboutStreet Cut public utility 986 Pleasant V 900040 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STRLET CUT PUBLIC UTILITY
DATE: 04/29/69 "
GIS ID:72900986 n Y FEE:_ .00
S.
MUNIS APPLICATION# 200900414 - : ' ` "_ E°' RATION DATE:
APPLICA T ...;3--i �' OCATION
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NAME: YANKEE GAS j,
"' y'. V E� 'SANT VALLEY ROAD
ADDRESS: 112 PROSPECT HIL' d x V¢'S C RISTOPHER L
EAST WINDSOR,C 8 't< F% PL tk ANT VALL RD
TH,, SOR,CT 06074
PHONE 860-292-2242 w '
N X
WORK DESCRIPTION: INSvveG ; . V �•_:�:i �, `
APPLICANT AGREES TO FURNISH THE V OF � ; T: ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN S '.� < O TENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T HE , T„ VJI � LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF �(� IT MANUAL.
ISSUED B DATE INSPECTED INSPECTED BY
4/29/200912:01PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: OQO�0 CONTRACTOR:
LOCATION: _
TYPE OF WORK: A I I
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--- -- DATE INSP NEEDED: DATE INSP: y is
- T INSPECTED BY:
WORK IN
PROGRESS:
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AS-BUILT:
INPUT: C DATE:
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W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT (1 o00 go
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
FEE $25.00
Name of Firm Q.YI 1 -�z° 6cLs Phone No.
Address of Firm S C
Location of proposed work VCc
Describe fully nature of permit requestedEr) li-a I I S __s 0 rvl CR1
Starting date oC _ Approx.time for completion
Call Before You Dig No. ®9'/700 0)0,-,7- Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
Est.Size of Perm. Patch(s)
Est. Pvt.Thickness in.
Est. Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check#
Permanent Patch
No. Cuts
-Size of Patch(s)
f 2Gt.5 oi-)- Final Billing
t. Due Payee
Amt. Due Town
By
Applicant is responsible for contacting 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 OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: lJ �J �� Date: l a 3"0 /
Title: Con S fM C (� (�C h- Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES