HomeMy WebLinkAboutStreet Cut Permits 315 Ferry Lane (2) 1300241 TOWN OF SOUTH WINDSOR CT
PERMIT NUMBER ,
STREET CUT PUBLIC UTILITY
DATE: 09/17/2013
GIS ID: 32700315
MUNIS APPLICATION# 201301353 / FEE: 0.00
= EXPIRATION DATE:
NA APPLICANT % LOCATIONME: YANKEE GAS V
ADDRESS: 112 PROSPECT HILL 21 j �RE R5 FEMY LANE
EAST WINDSOR, CT- RF
,BURG 4$
DORIS( 02
PHONE 860-292-2242
am V
% CIS R HILL,CT 06028
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WORK DESCRIPTION: EXC �!
V1;PTA m Ag T N ADJACENT TO 315 FERRY
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APPLICANT AGREES TO FURNISH THE TWFDUTI �� jr
THE TOWN OF SOUTH WINDSOR FOR ANX1' MO[J #1 BWND REQUIRED AND TO REIMBURSE
sVN--N- N R AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THILINT�S 1I�i W TAWL SIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OFiI WIIaISSTCpEIIT MANUAL.
ISSUED BY DATPJ LNCTED INSPECT D BY
9/17/2013 12:03 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 3 CONTRACTOR: 7a v1 Yee
LOCATION: S rlo_ (,a
TYPE OF WORK: 41ei i✓x qy�A)S5
DATE INSP NEEDED: DATE INSP: If 1 as 1�3
INSPECTED BY:
WORK IN
PROGRESS: W V Y. �,� ".n C w�g A V-L& U:Lx����
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: (ice DATE: l
W12007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION. PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR, CT 06074
FEE $25,00
Name of Firm {
Address.of Firm a(Z O - ,'` Phone Na_` 4 -
Location of proposed work iEcc,,—
6r09Eltr3:�/ 4y. 4
Describe fully nature of ` $ 3 i5
permit r uested sFLI{ �S 'P-00,v.
s Mp k
Starting date `? t��13
Calf Before Y_ ou Dig No. 2o1�3t✓Q its AbprnY,tame for completion �-
?-�t�3 �3 1 Traffic Services Control No.
Show sketch of proposed terorld famish
two copies of separate drawing indicate North This section to be filled out,
Town of South'Windsor
Pavement Cut
No.cuts
Est- of Penn.PatdXs)
l5 Est.Pvt.Thidmess
Est.Unit Price$
��--Glcis�sssn� Amt.of Deposit0/10 $
i Total Due b
O Cash )Check#
-- -�—I- — — Permanent Patch
No. 'Cuts
Size of Patch(s)
s fi w + ✓.��. Sinai Billing
Amt.Due Payee
Amt:Due Town
Applicant is re nsible for contadti
the Police Mint and C.B.Y.D. _
1 AGREE.TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT-OF BOND REQUIRED A
TOWN OF SOUTH WINDSOR.FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAI
AND TO REIMBURSE THE
CONNECTION WITH.THIS PERMIT AND THAT I AM FAMILY WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
PERM OUTLI ED b!JM�E TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. R WORK IN
NS FOR
Signed.-
Title,:
Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES