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HomeMy WebLinkAboutInstall CATV line Street Cut Permit 10 S TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3503 Cont.r:actor COX COMMUNICATIONS Location 0010 SYCAMORE ROAD Addre.sa 801ARKER `S.T. Type Work CABLE MANCHEST$ C.T (16040 `.CT 06040 Phone_;No Date Insp Needed ------------ Date ;nsp Time Insp Needed ------------ Time Inspected Byes ` , Work in Progress _ 7777-7 ------------- --------------------------------- if Input — A� Date ---��� Permit No. 3503 Town of South Windsor, CT Date 05/15/2003 Street Excavation Permit Expiration Date 05/14/2004 Descrip: Applicant Loca.t.i'on Name COX COMMUNICATIONS 0 `10 SYCAMQRE ROAD Addr. 801 PARKER ST 06040 CT 06040 Type of 'Work CABLE :, Phone (860)432-5211 Applicant agrees to::furnxS;h the..IoVdi`.`'fF tr h Windsor the amount of bond required and to resmbuYse thy; Townscar or any expenses incurred by the Town far ma ri`tenance or repair work ;n conhect;on with this permit and that applicant as :famiXsar / itE arse will abide^by the rules and regulations for perm as as outlinedxa th; Town of South. Windsor's Street Cut Permit Manual. * * PERMIT TO BE' KEPT ON JOB -SITE AT ALL: TI.MES. Issued by ----- — ----- -- Title:.: Date Completed f ----------------- Inspected By _ y 14 03 08: 28a Witch Ent. Utility Div 4138210955 p, 1 r APPLICATION FOR STREET EXCAVATION PERMIT TOWN OF SOUTH WINDSOR ,�- PUBLIC WORKS DEPARTMENT -� --- - s TOWN HALL �O t 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT - : $ Wolve ivame of Firm© At dress of Firm Phone No. Location of proposed work Describe fully nature of permit requested Starting date C Acars C211 Before You Dig No. Z 9�(v Approx.time for completion Traffic Services Control No. a '� Show sketch of proposed work or furnish two copies of separate drawing To be fill d out b rTown of Sout Windsor 'ndicate North Pavemen C�t -- Prop.size of cut i No. cuts Amt.of Deposit$ b ()Cash()Check# � Cut size after Perm. Patch No. Cuts Final Billing$ i Amt. Due Payee$ i Amt. Due'fawn$ Appficant is responsible for contacting the Police Dept. and C.B.Y.D. by date ,GRE—F 10 FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE SO!NTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNE PI+RMIT AND THAT I AM FAMILIAR WITH AND WILL ASIDE BY THE RULES AND REGULATIONS FOR PERM �E TOWN OF a e is SOU-i h WINDSOR'S STREET CUT PERMIT MANUAL. SON W ITH I$ IT'S AS OUTLINED IN THE sic^ec: �.r Date:_ Q Title:.,„ D.L.#: T SHALL BE KEPT ON JOBSITE AT ALL TIMES Standard Forms\Perrnits\Street Excavation Permit,doc ,-. 14 03 08: 20a Witch Ent. Utilit,,j Div 4138210955 p. 2 Mass: 888-344-7233 MgSafe.'6om pswrd 023WE Mass ID# DIG SAFE "7930 NUMBER 2003 0 CLEARS Qonr:800-922-4465 CSYD,Corn Pswrcr ON 91 A`TC'HEQU[P el—, —5/��7-�00 Contractor#1167 CITY DATE STREET ADDRESS AIR g M!fn 504 0-04 2L m.M QSS ST " 4, m gm�'1}SNGE IF IFIERIN T 24" CATV WORK A" A., MARKED ? YES -51N,1190,! OPP Rif NNO Pluromm-M, A. 0 Kb� pig NP, tip W,