HomeMy WebLinkAboutStreet Cut Permits 120 Hilton Drive (2) 1100092 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/22/11
GIS ID:44100120 FEE: 00
MUNIS APPLICATION# 201100779 EXPIRATION DATE:
APPLICANT LOCATION
NAME: YANKEE GAS - = AD-DRESS: 120 HIL' ON DRIVE
ADDRESS: 112 PROSPECT HILLS dWER. BEAGHAM DONALD E&DEBORAH L
EAST WINDSOR,CT 06488 i20 HILTON DRIVE
OT'Elf WINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: INSTA EWGAS SERVICE
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH INDSOR"TIiE AMOUNT-OF-BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANIF EXPENSES INCURRED BY THE TOWN]FOR-1tIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE A- LiCANT IS FAMli,IAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFOUTFI WINDSR'S STREET CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
7/22/20118:48AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: Vay)re'r', ("a 5
LOCATION: p I U`P
TYPE OF WORK: 2�
DATE INSP NEEDED: DATE INSP: ; Ia3�lL
INSPECTED BY: D
WORK IN
PROGRESS: 7'X 9 C.4
4y Ce• ILU �c GfVS
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE: f ---
W/2007 Town of South Windsor INPSECTION REPORT 07
07/,21/2011 THU 15: 35 FAX 860 292 2202 0002/002
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH'WINDSOR, CT
FEE $25.00
a Name of Firm "�"� Phone No. ` fib•- 'J 2 2�
Address of Firm i►'i- z.-t-
Location of proposed wo
Describe fully nature of permit requested N s �C
Starting date '7-7-6 t 1 Appro)L tkne for completion
Call Before You Dig No. Zeit 3co 5tl 3 Traffic Services C *d No.
RE Show sketch of proposed work or furnish _ To be mied out im Town of South Windsor
' two copies of separate drawing
ant ild
Indicate North Prop.size of at
id No.aft
�G Amt.of Deposit$ by
Cash Check
.� Cut size after Perm. Patch
. No. Cuts
Final Billing$
K.
AmL Due Payee$ -
-: G Amt. Due Town$
-:_
Applicant is responsible for contacting date
is 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.
Sin Date: `7-
u
;' Title• __ �L� D.L#:
PERMIT SHALL BE KEPT ON 3065ITE AT ALL TIMES
Standard FormAPermitAStreet Excavation Permitdoc