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HomeMy WebLinkAboutDrain Layers Permit 120 Austin Circle (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No.' 3072 Contractor COX COMMUNICATIONS Location 0120 Austin Circle Address 801 PARKER ST. Type Work CABLE MANCHESTER,CT 06040 CT 06040 phone,„`No. (860)432-5211 Date Insp Needed Date .Insp,. Time Insp Needed T rrie `Iry8p Inspected By • ���i�e�GTrIOy� Work in Progress ��,4' tr.�a T 10Js 713O 6�o ro AiW ztj` Date np Permit' No. fi tt' . _ (­o4ri r t�ut1 4+ "l riraso Date 02/22 �,Dtxe'at, f':xC;av a .1011 P&rtri -n s Exoi rat iorY'"'`bate 02/22/200 Descrip : App ! i c<�nt can Name t10;: COMMi_1NICA %UP4,C7 120 AtJStir1 rr, F fi Addr . 301 PARKf,=' , ST . 15040 CT 060401 Typa ""of Wor ,, C'A131-,_ i fi Phone ( :?60 )432--521 1 � Applicant ugr•t_E:,ti T6+�t't of South V,1i nasc>r the :An,o+anr_. of bond requirid and to rE� 1rrll�urso tie , Town cif South Windsor 'scar any ek,pen s-�s i 'incurred by ttrte Town 1 car Maintenance or r ei3c 1 r, work i ri c orinec vl1 oti with th'i s 3 permit ana T:ha,. apr7 1 1 :;ant --I s {'arEl" r w i t: 'w, I I a,t)1 cjEc, 0 v .hi_-_' r u I P,S a na i i equ i at i ons foi, perlii 1 s aL- ,out i 'i nett 11,1 t,r4e own (,)'f ;;oath Windsor , s Stree,c 'Gut. Pertio t Manual . i f'Ei N1i T'(t rat=: F Pt' ON, J::-)B sI IF, AT A i_ y 4 t Issued hiv Title f ii�oer ..ec� by Date Comp I .�i eri APPLICATION FOR STREET EXCAVATION PERMITJ��1 ' TOWN OF SOUTH WINDSOR - PUBLIC WORKS DEPARTMENT TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm © (3 Phone No. Address of Firm Location of proposed work >�® dlc c-n,y c ie, Describe fully nature of permit requested Li E Starting date - ? O I Approx.time for completion_ Call Before You Dig Naajor )-/6T^I LCa Traffic Services Control No. Show sketch of proposed work or furnish To be filled out by Town of South Windsor two copies of separate drawing Pavement r"�1t Indicate North Prop, size of cut No. cuts Amt.of Deposit$ by ()Cash( )Check# Cut size after Perm. Patch No. Cuts Final Billing $ Amt. Due Payee$ Amt. Due Town $ Applicant is responsible for contacting by the Police Dept. and C.B.Y.D. date 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 AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed:��:�n�� ,[j ,� '^(cup,-n Date: 0 Title: A D.L.#• PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES Standard Forms\Permits\Street Excavation Permit.doc Mass: Ph: 888-344-7233 Mass ID#17930 Fax 781-721-0047 DIG SAFE NUMBER 200105�7'aL o Conn: Ph: 800-922-4455 DIG SAFE CLEARS ON _a �_�/ AT 7:00 AM Contractor#1167 Date EMAIL MUNICIPALITY 15, (.4-, STREET ADDRESS & DESCRIPTION (Apartments&Condo's must list name of complex-Or list the number of feet from the cross st as well as N,E,S or W) ' oAST , ` e n CROSS STREET C'Yj �,( ST AREA MARKED ? YES WORK: Installing CAN Utilities Notified: — DEPTH: 1 I sl loe I �o i O d / Li C�-- a