HomeMy WebLinkAboutCAble Street Cut Permits 110 Country Vie TOWN OF SOUTH WINDSOR INSPECTION REPORT
Permit No. 3394 Contractor COX COMMUNICATIONS
Location F Address 801 PARKER ST.
Type Work MANCHESTER,CT
06040 CT 06040
(860)432-5211
Date Insp Needed n Cl
Time Insp Needed
Inspected By
Work in Progress
c�
n Date
P ' 'No. 3394 Town of South Windsor, CT
Ate " 09/19/2002 Street Excavation Permit
Expiration Date 09/19/2003
Descrip: . INSTALL CATV LINE
Applicant Location
Name COX COMMUNICATIONS OUN Y VIEW DRI
Addr. 801 PARKER ST. +
06040 CT 06040 CABLE
Phone (860)432-5211
Applicant agrees t Win sor the amount of bond
required and to rei b7T th cvc) or any expenses
incurred by the Tow a
to epa .k n connection with this
permit and that appl ' a ., ^ w bide by the rules and
regulations for perm 1 ne outh Windsor's Street
Cut Permit Manual .
el if
„ t O
* * PERMIT ALL TIMES.
Issued by R
Date Completed Inspected By P
Sep 17 02 03: 21p Witch Ent. Uti 1 ity Div 4138210955 p, 1
APPLICATION FOR STREET EXCAVATION PERMIT
0b : TOWN OF SOUTH WINDSOR
,� PUBLIC WORKS DEPARTMENT
a TOWN HALL
D 1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
w) VrE �
Name of Firm Phone No. GO
Address of Firm �.� ---
Location of proposed work Ito
Describe fully nature of permit requested 3. 4
Starting date a.�a.� OC? 3. Approx.time for completion (,—3 pit+.(,S W t�& Z, �,, e 1�,L{�-I t
Call Before You Dig No a Oars —Traffic Services Control No. `
Show sketch of proposed work or furnish To he filled out by Town of South Windsor
two copies of separate drawing
Pavement C��t'
Indicate North _ Prop,size of cut
No.cuts
/ A-rr
� Amt.of Deposit$ by
J, D, S ( )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.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: kl,,e_su�"'l_ Date: �L1 �3"
Title: 1 A D.L_#:
PERMIT SHALL BE KEPT ON]OBSITE AT ALL TIMES
Standard Forms\Permits\Street Excavation Permit.doc
Sep 17 02 03: 21p Witch Ent. Utilityfhiv 4130210955 p. 2
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