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HomeMy WebLinkAboutStreet Cut public utility 169 Brook Stre 1100001 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PUBLIC UTILITY DATE: 01/04/11y GIS ID: 14400169` s �i% / �� ;�� FEE: 00 MUNIS APPLICATION# 201100010 jA Adoi&IRATION DATE: � � APPLICAN7� � _ LOCATION NAME: YANKEE GAS -� RE 4 BROOK STREET ADDRESS:•. i112 PROSPECT HILL ��� y TGL-WIt DAVID J&COLLEEN M EAST WINDSOR,CTM 81 �/� -C-quo B I<OoK ST s PHONE 860 292 2242 r b* INDSOR,CT 06074 s s WORK DESCRIPTION. NEED EACS OVERLOOK TO HOUSXAT 1 ff APPLICANT AGREES TO FURNISH THE TJTI / FE-AMAIBSND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANI�N ES C I E r 16kQ_AINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THEMLAIaTXPMI L ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF S}}JTSR° STUT ' I:vIIT MANUAL. t1o � i ISSUED BY DA y/ S PECTED INSPECTED BY 1/4/2011'1:40PM 4*'PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** _... - .. ------ . -c- j. AM AM AW IN n y i N .. J go& y sue- y ji. _ /f TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.: CONTRACTOR: Lee. LOCATION: /6 9 r TYPE OF WORK: DATE INSP NEEDED: DATE INSP: INSPECTED BY: ffA WORK IN PROGRESS: CDC,.- r /'llo &' "f Pwc SQ Qn ^. 5 11.T ^ ©` bU-Jn J`r�rv► ri,.at G. q r 5 Q4 j0 r-, SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: (',M DATE: S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSORf CT FEE $25.00 Name of Firm N Phone Address of Firm Location of proposed work o V LO& Describe fully nature of permit requested tietD TV Get-, St EAS-L k"-*1 N A-SCRIS 'S 6%-,,e oo k 7--o 1 � Starting date 1- 7 1 t . - Approx.time for completion Cali Before You Dig No. `Z-,> 0 206 G ik Traffic services control No. Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate draw,ng Vim` wo Pavement Indicate North ° r _ Prop.size of cut No.cuts q, 5 tc�+`a� &ot,r+- Ta --Amt.of Deposit$ by O Cash().Check# cut size after Perm. Patch No. Cuts Final Billing$ Amt.Due Payee$ ti � ,00 K S•r- 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 SOUTH WINDSOR'S STREET CUT PERMIT MANUAL - Si ed• -. Date: Title: -F��t./� �/ D.L#: PERMIT SHALL BE KEPT ON 306SITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc Molloy, Catherine From: CallCenter@CBYD.com Posted At: Tuesday, January 04, 2011 8:17 AM Conversation: Locate Request-20110200598 Posted To: CBYD Subject: Locate Request-20110200598 (CALL BEFORE YOU DIG - CT) 01/04/2011 08:16:41 -5G -C1 -CW -GV -J1 -OT 1-SW SWINDS -T5 -------------------------------------------------------------------------- *** REMOTE BATCH ENTRY *** ***** ROUTINE ***** TIME. .08:16 DATE. .01/04/2011 REQUEST NO. . .20110200598 LATITUDE. .41.8627468 LONGITUDE. .-72.5532647 TOWN. . . . . .SOUTH WINDSOR ADDRESS. . .169 STREET. . . .BROOK ST NEAREST CROSS STREET. .OVERLOOK RD -------------------------------------------------------------------------- TYPE OF WORK. . . . .EXC TO INSTALL NEW GAS SERVICE AREA IS MARKED. . .YES REMARKS: WORKING ON OVERLOOK CROSSING ST AND GOING TO REAR OF HOUSE -------------------------------------------------------------------------- START DATE. . . . . .01/07/2011 START TIME. .07:00 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