HomeMy WebLinkAboutStreet Cut public utility 582 Graham Roa 900104 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER
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DATE: 07/31/09 0\ "``� "' °°\
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MUNIS APPLICATION# 200900908 �` v°` " v���" �\� �` � wvvv\v E TION DATE:
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APPLICAN „amv �� „ v qua OCATION
NAME: YANKEE GASv� v v� �����v1�\�� �\\� a�`` �u ,�
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ADDRESS: 112 PROSPECT HILL "W\""
EAST WINDSOR,C8 \\� af, \\\r R3�\; SALLY� ROAD
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SOP,CT 06074
PHONE 860-292-2242 ^m"
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WORK DESCRIPTION: INST L G� � �[ \� �\���\�101111��
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APPLICANT AGREES TO FURNISH THE TO �". ° °v" `"�° �o, ��'''�� "" w°�' �vv�
�' FOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE AP C n' I n SVILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SO 4\\aa�a NSm mEI �1n RMIT MANUAL.
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ISSUED BY IDATE INSPECTED INSPECTED BY
7/31/200910:41AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: °1 001 0 q CONTRACTOR:
LOCATION:
TYPE OF WORK:
--DATE INSP NEEDED: DATE INSP: d 1A CQ a
INSPEC'iED BY:_ BQ
WORK jN
PROGRESS: kc a 0, a- ccv
AS-BUILT:
INPUT: 6 DATE:
W/2007 Town of South Windsor INPSEMON REPORT 07
07/23/2009 THU 12: 52 FAX 860 292 2202 12002/002
APPLICATION FOR STREET EXCAVATION PERMIT 900 1 D t f
TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
TOWN HALL
1640 SULLIVAN AVENUE
SOUTH WINDSOR,CT 06074
�( FEE $25.00
Name of Firm 1��l ��.-�-� C�� Phone No.
Address of Firm (Z)5 2
Location of proposed work u► o ao-\
Describe fully nature of permit requested 10 5,+o l I Q-0 rv1 t�
Starting date En O S Lc Approx.time for completion a t5
Call Before You Dig No. :2 00 2:300 CA ( Traffic Services Control No.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
Pavement Cut
No.cuts
Est.Size of Perm.Patch(s)
Est.Pvt.Thickness in.
p >. 0,5-elan Est.Unit Price$
Amt.of Deposit$
Total Due$. by
( )Cash( )Check#
Permanent Patch
"5t_1 (�LtS i-tCki n Na. Cuts
3 'C Graham Size of Patch(s)
Final Billing
Amt.Due Payee
$
�/ j� Amt. Due Town
K.--P-J' $
By
Applicant is responsible for contacting Date
the Police De t.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 UTLINED IN TH TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: not tom( � aki, Date: ✓ '��
Title: t`� � eM• Driver's License#:
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
07/23/2009 THU 12: 52 FAX 860 292 2202 2001/002
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rM Nor&ell
Expanding Connecticut's Energy Options
Fax
To: --Joe- PerncL, From: ,
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Fax: (ALA -J Z R() Fax:
Phone: - d J i I Phone: ,l a j D--9
Pages: .1
Date: jt!)-?)�-o
Subject: Pl.()-ir- Mi 1`() S+cL.(l C Q se ry IC sue.
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