HomeMy WebLinkAboutStreet Cut Permits 9999 Nevers Road (6) 1000054 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 04/08/10
GIS ID: 62409999
FEE: 00
v\MUNIS APPLICATION# 201000352 w„ v,�v, EIRATION DATE: 04/08/11
APPLICANT ,vav
LOCATION
NAME: YANKEE GAS VER5 ROAD
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II ADDRESS: 112 PROSPECT HILL� � ��
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SOUTH WINDSOR
EAST WINDSOR, V
IVAN AVE4
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PHONE 860-292-2242 \ ��v \v ���`v�v � THvVIND R,CT 06074
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WORK DESCRIPTION: RELOQ, E S G GAS MAIN "I EVE`v � Al2K ��`R AND MILLER RD
A AS V ` �� AwygAAA \VAv VAAAVv��P��Vgv q vAgAAvAA ` ` \�4VVAv A�
AS PARTp OlV TH �NVEvv� AyvQSTI� CTIO°' PROJECT
APPLICANT AGREES TO FURNISH THE TQWNv� F� �J �`
1 P T m R ,AMl3U1�1 I OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI'EXPENSES�NCU1"1 \TIDE L °WN\FOR MAINTENANCE OR REPAIR WO IN
CONNECTION WITH THIS PERMIT AND THE 'PrCANT�S, AM IAIi W1� W L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SO\VTI,w II3SR�.„STREET SCUT PEZ'41T MANUAL.
PE 9AJA
ISSUED BY DATE INSPECTED INSPECTED BY
4/8/20108:48AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: )0D0c'4 CONTRACTOR: Y,a^�K �S C�-: ►�. Wui
LOCATION: "AP
TYPE OF WORK:_ Yv c�; �i�15 ,,—�'�G G A 5 fnAt�
DATE INSP NEEDED: DATE INSP: -L7 !�
INSPECTED BY:
WORK IN
PROGRESS:__ k'���n i a w5,91_ d;�
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W12007 Town of South Windsor INPSECiION REPORT 07
0"t_ Z�icoc� �� APPLICATION FOR STREET EXCAVATION. PERMIT 1 ce�S4
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FE
Name of Firm � �' Phone No. "-79"2 -2-Zi9
Address of Firm I.12- N i l t '�2e�c� , �� ., ,�,c� a� c;r .
Location of proposed work
Describe fully nature of permit requested 11.E
Starting date 5 1 Approx.time for completion
Call Before You Dig No. 2D 140 c.�2� Traffic Services Control No.
Show sketch of proposed work or famish
two copies of separate drawing Indicate North This section to be filled out by
Town of South'Windsor
Pavement Cut
No.cuts
Est.Size of Penn.PatdXs)
fT Est.Pvt.Thickness in.
I wo M.V'1'j I g� �! �, Est.Unit Price$
_ Amt.of Deposit$
Total Due$ by
)Cash( )Check# .
Pr,n Permanent Patch
No. Cuts
i Size of Patch(s)
Final Billing
Amt.Due Payee
Amt:Due Town
By
Applicant is re risible for contactina
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 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMITS. U INE THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: °�� � 1`�,'��-��� ,
Date:_ � /13
Title:"- c��a�} - �
Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES