HomeMy WebLinkAboutReplace existing CATV Street Cut Permits 700097 TOWN OF SOUTH WINDSOR, CT
PERMIT.NUMBER STREET CUT PERMIT
DATE: 06/25/07
GIS ID:47100024
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FEE: 25.00
MUNIS APPLICATION# 200700959
RATION DATE: 06/24/08
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P LI C A NT>
L CA TI O N
NAME: _ >
TELE NETWORKS Y;<s
ADDRESS: 31 _. ...
RES. :-r'''s2 BEAN LANE
AKEWELL COU
CRA # �. TH E
STON RI 02921 ,3 "-:w "`::
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WORK DESCRIPTION: REPIAC
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APPLI
CANT
CA NT AG
REES
E ST OF FURNI
SH TH
E
TOWN . ?R kMOUI .O GNP REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANt.E7 :NSE,9.1 ry .$ z .T�}} 'F MAINTENANCE O' R REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE'` PP CA T<IS`F x . A:.-
L1,ABIDE BY THE RULES AND REGUL
FOR PERMITS AS OUTLINED IN THE TOWN OF`SOU ,."W.II�tbsRa CIJT:I?.1~RMI I MANUAL. ATIONS
ISSUED BY
DATE NSF D INSPECTED BY
7/9/200711:08AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT.
PERMIT NO.. 76o 0 9'7 CONTRACTOR:
LOCATION:_?=n LL� ADDRESS:
TYPE OF WORK: ►2.e to ce cFk;,,Iin C, r A
DATE INSP NEEDED: DATE INSP: �10
INSPECTED BY:__ Qj�_
WORK IN
PROGRESS: i� rx
.INPUT: c*V DATE:_ oZ-1 3- 0
APPLICATION FOR STREET EXCAVATION. PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL
1540 SULLIVAN AVENUE
_SOUTH WINDSOR, CT 06074
FEE $25.00
'Name of Firm -E��-
Phone No.
Address ' �3� —
U
Address of Firm I 1 ,!'�C '!, ('2 �tS f 7 �)-c� 11
Location of proposed work JEgw' GN,
Describe fully nature of permit requested 1Z<EP6k3-6E 4 k(.!?f'j,AJ6 Coe*rV
Starting date "3 2 ''"O Call Before You Dig No.. Approx. time for completion 1 O
00
Traffic Services Control No.
Show sketch of proposed work or furnish
two copies of separate drawing Indicate North This se7"�n
ed out by
�� f}ff AC H C� Towindsor
Pavement
No.cuts
Est.Size of )
Est PvL Thiin.
Est.Unit PriAmt.of DepTotal Due$ by
( )Cash( )Check# .
Permanent Patch
No. Cuts
Size of Patch(s)
Final Billing
Amt.Due Payee
Amt.Due Town
By
Applicant is responsible for contacting
the Police Dept.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 AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Stdned:
Date:
(it,-�_ 70 J-1 - VV\N G Z. Driver's License#:
PERMIT SHALL.BE KEPT ON JOBSITE AT ALL TIMES
0511012007 14: 56 CONNECTICUT CALL BEFORE YOU 016 Page 1
(CALL BEFORE YOU DIG - CT) 05/10/2007 14: 56: 03
-56 -C1 -G5 -GV
-OT 11-SW SWINDS -T5 -W3
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***** ROUTINE *****
TIME. . 14: 55 DATE. . 05/10/2007
REQUEST NO. . . 20071903595
LATITUDE. . 41. 8046743 LONGITUDE. . -72. 5831186
TOWN. . . . . . SOUTH WINDSOR
ADDRESS. . . 24
STREET. . . . JEAN LN
NEAREST
CROSS STREET. . MARGARET DR
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TYPE OF WORK. . . . . EXC TO INSTALL CATV
AREA IS MARKED. . . YES
REMARKS:
WORKING FROM THE PED LC ON LEFT FRONT OF PROPERTY AND GOING
TO PED LC ON RIGHT FRONT OF PROPERTY
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START DATE. . . . . . 05/15/2007 START TIME. . 08: 00
CALLER. . . . . . . . . . JAMES DAMBRA
CALL BACK. . . . . . . 8-5
PHONE #. . . . . . . . . 888-845-2302
FAX #. . . . . . . . . . . 401-942-1630
ALT. PHONE #. . . .
EMAIL ADDRESS. . .
CONTRACTOR. . . . . . TELE-NETWORKS
ADDRESS. . . . . . . . . 561 SCITUATE AVE
CITY. . . . . . . . . . . . CRANSTON
STATE. . . . . . . . . . . RI
ZIP. . . . . . . . . . . . . 02921
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EXCAVATOR DOING WORK. . SAME
ISSUED TO: DATE: TIME: BY:
DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY:
CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY:
PERSON CONTACTED: PERSON CONTACTED: