HomeMy WebLinkAboutStreet Cut Permits 524 Sullivan Avenue (2) 1200154 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 08/22/12
GIS ID: 87300524 FEE
MUNIS APPLICATION# 201201086 ExPTRATTnN nATR•___
APPLICANT = LOCATION
NAME: YANKEE GAS ADDRESS; 524=-gUaIVAN AVENUE
ADDRESS: 112 PROSPECT HILL RD " TER CIARBQNNEAU ANDRE
EAST WINDSOR,CT006'0 125 1 ffrw RD
- SOUTH V INDSOR,CT 06074
PHONE 860-292 224E
WORK DESCRIPTION: INSTALL G SERVLCE /
THE DRAIN LAYER ASSIGNED TO THIS P-_ERMII�IAS AAIIytCEj-E IS (JEDY TIDE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORT141 TI3I ATT G IS CC7I DII I6N,-- ALL__OkK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,AI,L OSHA REQUIREMENT AMID THE ATTACHED CONDITIONS.
ISSUED BY DATE INSPECTED INSPECTED BY
8/22/2012 11:26 AM
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: /a 6v is y CONTRACTOR: yA yl._e_e t',4S
LOCATION:__ S,2 V S 11ll i vim✓) 4vPg tie
TYPE OF WORK:_ - Q,,S jL.- Se,-y1c<f
DATE INSP NEEDED: DATE INSP: --�2'1-13
INSPECTED BY: 61>
WORK IN
PROGRESS:—Ne,_J
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION. PERMIT
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
Name of Firm 4,1kW cx.�-
Address of Firm ►l 2 ►gyros �! ) Phone No. &1_;),'-o—Z92--22iq
Location of proposed work Svc .5,tliv,4
Describe fully nature of permit requested
Starting date � 1 !y
Call Before You Dig No.
ApproX time for completion � • ra
Zo12330 �o
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.Patch(s)
1 �— Est Pvt.Thickness in.
2� Est Unit Price$
Amt.of Deposit$
1 Total Due$ b
( )Cash( )Check#
— cis _
Permanent Patch
No. Cuts
Size of Patch(s)
i Final Billing
I $
- Amt.Due Payee
a
-,5�)ILJV,� AV Amt Due Town
' gY
Applicant is r wnsible for contacti
gg
the Police De t.and C.B.Y.D. atP
1 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
PERMIT UTLINED IN TOWN OF SOUTH WIN R'S STREET CUT PERMIT MANUAL.
Signed:
D ate:
Title:_TplrD ' `!
Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Molloy, Catherine
From: CallCenter@CBYD2.com
Sent: Monday, August 20, 2012 7:55 AM
o:
Subject: Locate Request-20123400126
(CALL BEFORE YOU DIG - CT) 08/20/2012 07:54:32
-5G -C1 -CW -GV
-Jl -OT 2-SW SWINDS -T5
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*** REMOTE BATCH ENTRY ***
***** ROUTINE *****
TIME. .07:54 DATE. .08/20/2012
REQUEST NO. . .20123400126
LATITUDE. .41.8517931 LONGITUDE. .-72.5813927
TOWN. . . . . .SOUTH WINDSOR
ADDRESS. . .524
STREET. . . .SULLIVAN AVE
NEAREST
CROSS STREET. .KENNEDY ROAD
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TYPE OF WORK. . . . .INSTALL GAS SERVICE
AREA IS- MARKED. . .YES
REMARKS:
AREA IS MARKED. EXCAVATION TO BEGIN ON KENNEDY ROAD AT ENTRANCE TO NEW FEDEX BUILDING.
EXCAVATION TO CONTINUE ALONG DRIVEWAY TO FRONT OF FEDEX BUILDING.
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START DATE. . . . . .08/23/2012 START TIME. .08:00
CALLER. . . . . . . . . .DOUGLAS MACPHERSON
CALL BACK. . . . . . .7:30-4
PHONE #. . . . . . . . .860-292-2219
FAX #. . . . . . . . . . .860-292-2202
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . .YANKEE GAS SERVICES
ADDRESS. . . . . . . . .112 PROSPECT HILL RD
CITY. . . . . . . . . . . .EAST WINDSOR
STATE. . . . . . . . . . .CT
ZIP. . . . . . . . . . . . .06088
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EXCAVATOR DOING WORK. .YANKEE GAS / NPL
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:
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