HomeMy WebLinkAboutStreet Cut Permits 9999 Kelly Road 1100084 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/13/11 "
GIS ID:49509999 ; " - - FEE: .00
MUNIS APPLICATION# 201100740 = EXPIRATION DATE:
APPLICANT LOCATION
NAME: YANKEE GAS KBLLY LOAD
ADDRESS: 112 PROSPECT HILL:2D„- = = OWI E1, dUT INDSOR TOWN OF
EAST WINDSOR,CT DW81 T50-SUL�dVAN AVE
fl7T WINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: RELOCEiA Mt�1N BETWEEN AVEY STREP�T AND WILLOW STREET ON
KELL
APPLICANT AGREES TO FURNISH THE lb SOUTH NDSOR TPiE AMOUNT OrROND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANYXPLI�ESNCURREI)B THE 1 OWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE A P I AN T IS FAME IAR WITH AND W-J-LL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TO WN OF SIIUTH WINDSR'S STREET CUT P'RI lT MANUAL.
if
ISSUED BY DATE INSPECTED INSPECTED BY
7/13/201111:10AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: I ' 000 y CONTRACTOR: V a n vee
LOCATION: Ratka &4wu ee n QW ZV_U 4- w I1 n A)
.TYPE OF WORK: R e f Dcako_ 2as vno, t,_
DATE INSP NEEDED: DATE INSP: /� /z
INSPECTED BY: r3 n
WORK IN
PROGRESS: G 5 /''►�;,V w c. s i�l uc ;z-��? :� •9-irc'i'
/ �� ft1
/ ift�Y� d'15 �tJi�e��Jr�rs/ � 4
C YID- !�
47
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L, DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION. PERMIT iloc��
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25.00
'Name of Firrn_ ynkccl CAs Phone No. �--Z�Z-2z1
Address of Firm 12 �fi 19
41
Location of proposed work let I I r<
• U
Describe fully nature of permit requested To A440i be,f-ea-,
Starting date Zs '7 t I
Approx.time for completion .12 15 201 1
Call Before You Dig No. Traffic Services Control No.
Show sketch of proposed work or furnish
two capes of separate drawing Indicate North This section to be filled out by
Town of Eouth'Windsor
Pavement Cut
No.cuts
r Est.'Size of Penn.Patch(s)
EsL Pvt.Thickness in.
J EsL Unit Price$
3 Amt.of Deposit$
I Total Due$ by
Cash( j Check#
Permanent Patch
No. Cuts
Size of Patch(s)
i Final Biging
NiAtft�+� tl`% VAfzicUS $
i LcC aTpr+S P�� Amt.Due Payee
ca-r-/ $
F( ► 4,9,6. Amt Due Town
I $
BY
Applicant is responsible for contacti
the Police Dept.and C.B.Y.D. Date
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. 0 IN THE TOWN OF SOUTH WINDSOR'S STREET CUT P RMIT MANUAL.
Signed: Date: r716
Title:
Drivers License#:
PERMIT SHALL BE KEPT ON JOBSITE.AT ALL TIMES