HomeMy WebLinkAboutCAble Street Cut Permits 21 Christine La TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3306 Contractor COX COMMUNICATIONS
Location Address 801 PARKER ST.
Type Work MANCHESTER,CT
06040 CT 06040
j5hone (860 )432-5211
Date Insp Needed I4s 02%
Time Insp Needed
Inspected By
Work in Progress
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Peit: No. 3306 Town of South Windsor, CT
Date 05/30/2002 Street Excavation Permit
Expiration Date 05/30/2003
Descrip: INSTALL CATV LINE TO HOUSE
Applicant Location
Name COX COMMUNICATIONS C4R INE LANE
Addr. 801 PARKER ST.
06040 CT 06040 CABLE
Phone (860)432-5211
Applicant agrees h i or the amount of bond
required and to reim u o ` th r any expenses
incurred by the Town e a pai i connection with this
permit and that appli an ide by the rules and
regulations for permi f th Windsor' s Street
Cut Permit Manual .
t
* * PERMIT T T L TIMES.
Issued by �. �C n1ASniD .
Date Completed Inspected By � , �=
jP28 02 10: 56a Witch Ent. Utility Div 4138210955 P. 5
APPLICATION FOR STREET EXCAVATION PERMIT �3°�
TOWN OF SOUTH WINDSOR -
.� PUBLIC WORKS DEPARTMENT
/ �° �+� TOWN HALL
�p 1540 SULLIVAN AVENUE
SOUTH WINDSORF CT .
FEE .
Name of Firm L+O c F t 7 1�..�,�I c� Z ,Phone N0. Y 420
Address of Firm-- I n� Q�,.S� P
Location of proposed work
Describe fully nature of permit requested
Starting date Approx. time for completion — * ea
Call Before You Dig No.aJdO a *A is 3a Traffic Services Control No. t AV
Show sketch of proposed work or furnish To be_fllled out by Town of South Windsor
two copies of separate drawing -----
R4y=eflLCUt
Indicate North Prop.We Of cut
No. cuts
Amt.of Deposit$ by
()Cash()Check#
D�
G 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���, mad}
Title: M-A D.L.#:
PERMIT SHALL BE KEPI'ON JOBSITE AT ALL TIMES
Standard FormsWermits\Street Excavation Pemtit.doc
28 02 10: 56a Witch Ent. Utility Div 4138210955 p. 6
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