HomeMy WebLinkAboutStreet Cut Permits 9999 Dart Hill Road (3) 00046 TOWN OF SOUTH WINDSOR, CT
PERMIT 1 JJMBER STREET CUT PUBLIC UTILITY
DATE: 04/01/2014
GIS ID:25809999 FEE: 0.00
MUNIS APPLICATION# 201400302 - - EXPIRATION DATE:
APPLICANT
LOCATION
NAME: YANKEE GAS ADDRESS DR HILL ROAD
ADDRESS: 112 PROSPECT HILL ? AtQWNR TOW1�OF SOUTH WINDSOR
EAST WINDSOR,GT (98 = i5" JLLIVAN AVE
SOJ JTI WINDSOR,CT 06074
PHONE 860-292-2242 - -= ;
FE
WORK DESCRIPTION: YAI`iKF�ErAS GRAIN R-iTOWIN
IN IO BI;TWBN 4Q AND 69 DA1TLRb
APPLICANT AGREES TO FURNISH THIS TOWN OF- IT WINDSCIR THE AMOJ VT OF BDND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AEI ' XPIyNSES II UR1 D BY THE TOWN FdR- AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND IJIE APPLICANT IS FAII�TAR W13I ANT}WILL ABIDE BY THE RULES AND REGULATIONS
Mt-
FOR PERMITS AS OUTLINED IN/THE TOWN&,SbUfH WINDSIV S STRET TCUT kERAIT MANUAL.
ISSUED BY itA E INSPECTED INSPECTED BY
4/1/201411:30AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR: U-
v
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP: tf 1
INSPECTED BY: 6f 1 t 0
WORK IN
PROGRESS: yj ON, r It c
1
/Ip-/I 1 pgj `
_ ♦ iv 'Y+ •L - ♦ -® �i,,e ICY e,Yl ■ 4E' !iIL cli �(
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: - DATE: - 11
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION
t; TOWN OF SOUTH WINDSOR . PERMIT (LM q6
PUBLIC WORKS DEPARTMENT Permit No.
i I TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
�� FEE $25.00
}- NamAddi e of_Firm rm
ro o — 219.. l ( a c/ I W no(Bar C - G �
Location of proposed work
}ge e h�see A-4 69
;.
{ Describe fully nature of permit requested ESxc__.,�e
t.
M41h
• Starting date I
Approx.time for completion 1
Call Before You Dig No. 7$ /tom r ,� /tf
i Traffic Services Control No.
i Show sketch of proposed work or famish
a;.
two copies of separate drawing This section to be filled out b
Indicate North
` Town of South'NIndsor
Pavement Cut
If No.cuts
t
Est.-Size of Perm.PaldXs)
Est.Pvt.Thickness
Est.Unit Price$
Amt.of p'Posit$
1
D Total Due
: by
Cash( >Check
Permanent Patch
a No. Cuts
'Y 12"S' Size of Patch(s)
Finaf Bi(ling -
Amt.Due Payee
�Gra.n Pray j ect $
Amt Due Town
By .
licant is re Bible for contact(
the Police De t.and C.B.Y.D. _
- i AGREE.TO FURNISH TO THE TOWN OF SOUTH WINOSOR THE AMOUNT OF BOND REQUIRED ANO TO REIMBU
RSE THE
=,... •.TOWN OF SOUTH WINDSOR.FOR ANY
CONNECTION WITH PERMIT AND THAT I AM FAMILIAR W. IITH AN WILOL ABIDE BY THIS RULES CE ORAND RERGEPAIR WORK IN
P IT I IN THE TOWN OF S WINDSOR'S STREET CUT PERMIT MANUAL. LATIONS FOR
Signed: o
Date: 3Z3) f
Ti :tle
Driver's License 0.
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES