HomeMy WebLinkAboutInstall/replace CATV between 74 and 78 S 700163 TOWN OF SOUTH WINDSOR, CT
.PEWHT NUMBER
... STREET CUT PERMIT
DATE: 10/02/07 x.. w. . £M.s
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GIS ID: 82500074
FEE: 25.
MUNIS APPLICA
TION
ON# 2 20070
1600
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0/01/08
APPL
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:L OCATI ON
NAME: TELE-NETW r p.
ORKS
';SDI�k. N D
S ARCJ RIVE
ADDRESS: 3 >�"� <:•x..::1 BAKEWELL COI7LT. .
:> f'
IER kONALD A&CAROLANN
CRASTON RI02921
SUOONDRIVE
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I�=:.WINDSOR,C T 060743448
.:Y.p4;t Y:• ? �
PHONE -40 - >€:
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WORK DESCRIPTION: IN ` °.y
STALI CREPT Ac E CATV B�WEEN 74 NP 8. HAItON DRIVE
l
APPLICANT AGREES TO FURNISH THE TQt N"- F"S'. f ` :.fiJI;�V � HTy. 4 OJNTF$tND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AN-'iWENSt C: '..P# >Ip FOI?` AINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE ?PLIT ' P 'WITI AI*T])WALL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOU, W... R'S S `, RMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
10/2/20072:55PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: CONTRACTOR:
LOCATION:_
TYPE OF WORK: 1 U1 A l l I ,D
DATE INSP NEEDED: DATE INSP:Aj�ag
INSPECTED BY: 8�
WORK IN
PROGRESS:__
1
AS-BUILT:
INPUT: DATE:__ 1 D
W/2007 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_'TIE LE NETwo KKK Phone No. •$4S-23o2-
Address of Firm3i 1::;_:WCI,1. C` N N F—T 02,R2I
Location of proposed work
Describe fully nature of permit requested_
Starting date 0 -d 7 Approx. time for completion_ I
Call Before You Dig No.2-yU"1 Z1 1 ,17)
Traffic Services Control No.
Show sketch of proposed work or fumish
two copies of separate drawing Indicate North This section to be filled out by
SE✓a AITACK-€D Town of South'Windsor
Pavement Cut
No.cuts
Est.'Size of Perm.Patch(s)
Est.PvL Thickness in.
Est.Unit Price$
Amt.of Deposit$
Total Due$ by
( )Cash( )Check# .
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contactigg
the Police Dept.and C.B.Y.D. —
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
PERMITS AS _UTLI N THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Si ned: � Date: 1_,>L/'G-
Title. Driver's License#:
___PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES