HomeMy WebLinkAboutCAble Street Cut Permits 400 Chapel Road TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. . 3230 Contractor COX COMMUNICATIONS
Location Address 801 PARKER ST.
Type Work CABLE MANCHESTER,CT
06040 CT 06040
Pone No. (860 )432-5211
Date Insp Needed Date -Insp. /2�/ �Ol
Time Insp Needed Timms Tnsp
Inspected By %`"�
Work in Progress �•�y ,av �-F -fi' '�G� ,��� ,�/
Input, Date
Permit No 3230 Town of South Windsor, CT
Date ' 11/16/2001
'- Street Excavation Permit
Expiration Date 11/16/2002
Descrip:
Applicant Location
Name COX COMMUNICATIONS
Addr. 801 PARKER ST. O�}QP`C14APF-L ROAD
06040 CT 06040
Phone (860)432-5211 Type -4f Work CABLE
Applicant agrees to f urn a s`h the_' p r o , S.Uth Windsor the amount of bond
required and to reimburse the ;town,. "'SOU Wl,n( .sor for any expenses
incurred by the Town fpr. m&T»tenal'ice or-,repair work _in connection with this
permit and that applicantami 1 iar ► - th tl and"* 1 1 ab'i de by the ru i es and
regulations for permits as 6u e #. in he own �o,f South Windsor's Street
Cut Permit Manual . ",
* * PERMIT TO BE , KEPT. ON . JOB .S.ITB AT ALL TIMES,
Issued by
T-i t1eolo y
Date Completed --
-� _^Inspected By
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR ---
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $25.00
Name of Firm (D Q Phone No. 17(00 —S l ' S _.50
Address of Firm
Location of proposed work gto-t o1 CAAApet T�b4
Describe fully nature of permit requested Tip. ; CAVV LtwbE:
Starting date Approx. time for completion 1 —?, QA- `C
Call Before You Dig No. c�C ` l4(0�`�®'ICI Traffic Services Control No.
Show sketch of proposed work or furnish To be filled out by Town of South Windsor
two copies of separate drawing
Pavemen � t
Indicate North Prop. size of cut
No. cuts
Amt. of Deposit$ by
( )Cash( )Check#
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.S.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 CONNEC`iON 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:
n ` 'L Date:
Title: D.L.#:
PERMIT SHALL BE KEPT ON 70BSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
- Maw: 888-344-7233.
Fx 781-721-0047 DIG SAFE 2001 � Gj CLEARS 7:00
Mass 1D#17930 ; NUMBER 460 ,�C) / ON ll AM
Conn:800-922-4455
Fx 203 248-6448
Contractor#1167 CITY
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