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HomeMy WebLinkAboutInstall CATV line Street Cut Permit 41 A Permit No. 3480 Town of South Windsor, CT Date 05/05/2003 Street Excavation Permit Expiration Date 05/04/2004 Descrip: Applicant Locartion. Name COX COMMUNICATIONS 4941 ANDMAR LAI7 K<� Addr. 801 PARKER ST. 06040 CT 06040 Type of %'Work CABLE Phone (860)432-5211 Applicant agrees to `furn�sfi the ;:Town o South Wiricsor the amount of bond required and to reiM-bburse the:,TowYi of South S�irsClsor for arip expenses incurred by the Town-_:for main_ 'tenance or repi4.; work in Co#in..ectxbn with this permit and that applicant is fam3xar ssi _h aid- will :abide by the rules and regulations for permits`as outlined`:: in the Towri of &auth Windsor's Street Cut Permit Manual. * * PERMIT TO BE,KEPT ON JOB SITE AT ALTO TIMES. Issued by ___-- Title ---�---- �— — ------------------ Date Completed Inspected By ___ A TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 3480 Cont ractor„CgK,;CQMMVICATIONS Location 0041 ANDMAR LANE }� Addr..ss 801 PARKER ST. Type Work CABLE MJ3NC FE:6.TER C1 - A5(14(S .CT 0604`0 Phone'...No $6 )43L 5211': Date Insp Needed ___ _______ Daten� Time Insp Needed ________ Time ITtp Inspected By Work in Progress Pa.. Of Input Date vz�/--0 3 VO APPLICATION FOR STREET EXCAVATION PERMIT �� : TOWN OF SOUTH WINDSOR a - PUBLIC WORKS DEPARTMENT / 6. TOWN HALL 1 d ; 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT FEE $25.00 Name of Firm © d Address of Firm phone No. M Location of proposed work Describe fully nature of permit requested Starting date Call Before You Di No. Apprax.time for completion (— gam` tyst� er Qr,x, —r g Traffic Services Control No. Snow sketch of proposed work or furnish To be filled out by Town of South Windsor -�%—copies of separate drawing Pavement ut Indicate North Il Prop.size of cut No.cuts Amt. of Deposit$ by {� ( )Cash()Check# Cut size after Perm. Patch I No. Cuts i Final Rifling$ Amt. Due Payee$ Amt. Due Town$ Applicant is responsible for contacting by 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 5��-:, b'lTNDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS oERMFT-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: Dater[ T itie: D.L.## T" PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES S amoa;- arms\Pennits\Street Excavation Permit.doc P• a ?33_g44-7233 —.Safa:om PSwrd DIG SAFE CLEARS riasstD NUMBER 2003 1803540 ON 5/7 7:00 Conn:800-922.4455 .^ n V B11TC EQ Pswrd � V4ITCHEQUIP CITY � Contractor#1167 DATE I /' I03 STREET ADDRESSeZ vco .N...... MkxFr�_ k'4.�.L:.,-• ._.i'lid...�.u�j .'yl°. �.R -.u?� �/ . _. OSS ST v ((ice ` - Ll < : EIFDIFFERENT 24'" CATV WORK MARKED ? YES �•s xti TR 3 4+•a 1' -Y �R*Cgdi�kq�t�.xw} y dxY� A 77ir:MFS,72 d 6 M, ;,'. f 4 L