HomeMy WebLinkAboutInstall CATV line Street Cut Permit 68 A p rm No. 3302 Town of South Windsor, CT
,. bate 05/30/2002 Street Excavation Permit
-,xpi ratitbn =Date 05/30/2003
Descrip: INSTALL CATV LINE TO HOUSE
Applicant Location
Name COX COMMUNICATIONS T DRIVE
Addr. 801 PARKER ST.
06040 CT 06040 CABLE
Phone (860)432-5211
Applicant agrees h or the amount of bond
required and to reim u o th r any expenses
incurred by the Town - e an pai ti connection with this
permit and that appli f ° „ an ide by the rules and
regulations for permi 1 f th Windsor's Street
Cut Permit Manual . ,
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PERMIT
T
T LL TIMES.
Issued by
Date ,Completed Inspected By
TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No.
2 — Contractor COX COMMUNICATIONS
Locationj "DO Address 801 PARKER ST. 4 'r
Type Work LE MANCHESTER,CT
06040 CT 06040
e (860 )432-5211
Date Insp Needed s 1 p lei
Time Insp Needed
Inspected By
Work in Progress
t
OR
6 Date �,
May 29 02 07: 43a Witch Ent. Utility Div 4138210955 P, 1
APPLICATION FOR STREET EXCAVATION PERMIT
DSO TOWN OF SOUTH WINDSOR --
PUBLIC WORKS DEPARTMENT 3 '
' �� TOWN HALL
?� �®� 1540 SULLIVAN AVENUE
�% SOUTH WINDSORf CT
ffE $2!5. 1 V E b
Name of Firm 6 073 Phone Na. o " S 1 _)"rx D
Address of Firm !'Lcr
Location of proposed work
Describe fully nature of permit requested i►_; t r` i Crt �` Lij 6
Starting date Z, Approx.time for completion i—3 VjA-A;S
Call Before You Dig No. o? d Traffic Services Control No.
Show sketch of proposed work or fumish To be frllgd out by Town of South Windsor
two copies of separate drawing
PavemgrtCut
Indicate North Prop.size of cut
No. arts
Amt.of Deposit$ by
S� ( )Cash( )Check#
G„P Cut size after Perm. Patch
No. Cuts
Final Billing$
Amt. Due Payee$
Amt. Due Town $
Applicant is responsible for contacting by date
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.
Signed:- Date: 01?, "Z100�-
Title: D.L.
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
,May 29 02 07: 43a Witch Ent. Utility Div 4130210955 P, 2
Mass: 721-0 47233 2 2^/�0848 6/1
Fx 781a21-oo47 DIG SAFE �V O� (J.,C G�VNV� CLEARS 7:QQ
Mass ID#17930 NUMBER ON AM
Conn:800-922.4455
Fx 203 248-6446 1
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Contractor#1167 f`�Tl/ ' ^� �
DATE
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ADDRESS
49
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